الفهرس 
Patients and MethodsOnly 14 pages are availabe for public view
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Abstract
Hypersplenism is a clinical syndrome characterized by enlargement of spleen, reduction of at least one cell line in the blood in the presence of normal marrow function and evidence of increased release of premature cells such as reticulocytes or immature platelets from the bone marrow into the blood.
Surgical removal of the hyper functioning spleen in the setting of cirrhosis, even with less invasive laparoscopic techniques, carries a significant risk of morbidity and mortality, with 25 % of splenectomy patients developing portal vein thrombosis and a small number forming sub phrenic abscesses.
After development of PSE by Spigos and colleagues, PSE began to take lead as a safer and effective solution for hypersplenism.
However, PSE was associated with many complications such as intermittent fever, abdominal pain, nausea, vomiting (post embolization syndrome) splenic abscess, splenic rupture, pneumonia, refractory ascites, pleural effusion and gastrointestinal bleeding.
With the development of local thermal ablation modalities such as RFA, MWA and HIFU, as alternatives for PSE.
The most frequent complication associated with MWA was mild tolerable pain that responded to analgesic.
Ultrasound-guided percutaneous MWA is both a safe and effective treatment for hypersplenism in cirrhotic patients without any of the serious complications seen in other treatment modalities.
Goals of future studies should include:
1. Refinement of MWA techniques, determination of ideal ablation volume, and the standardization of indications, contraindications, and appropriate post-ablation follow-up management.
2. Furthermore, future larger studies following patients over longer periods post-ablation would be beneficial to estimate MWA’s impact on disease specific morbidity and mortality, to allow MWA to emerge as a frontline therapy in the management of cirrhosis-related secondary hypersplenism.
Limitations of the study:
Small sample size, inability to do CT for all patients due to low socioeconomic status of most patients.