chapter  16
6 Pages

CO2 Splenoportography

WithIrvin F. Hawkins

CO2 Splenoportography (SPG) was performed in eight patients (five pediatric, three

adult) via percutaneous trans-splenic placement of a 25-gauge needle. Five to thirty cc

of CO2 were injected using the plastic bag delivery system, which filled the majority of

the portal system in all patients with no evidence of bleeding complications. All studies

were performed due to equivocal findings with noninvasive imaging. SPG answered the

necessary questions for surgical planning. We feel that the study is most important in

small infants, who have a higher risk of femoral artery access complications, and

patients with hepatofugal flow, where indirect portography may give a false-positive

diagnosis of portal vein occlusion.