Technique, Hazards, and Usefulness of Percutaneous Splenic Portography

Percutaneous splenic portography is the diagnostic injection of a radiopaque solution into the spleen. This is done with the patient under general or local anesthesia, and the solution is delivered rapidly into the splenic pulp as near as possible to the hilum; a series of roentgenograms is then made at 2, 4, 6, 8, 12, 16, 24, and 32 seconds from the start of the injection. The technique here described includes many essential precautions and yields manometric data on the pressures existing within the spleen and portal system. Experience with 266 portograms has enabled the authors to anticipate possible difficulties and complications and has demonstrated the value of diagnostic information so obtained in cases of disturbed portal circulation.