The functions of the spleen are hemofiltration, purification, and immune function, but for a long time, the spleen has been said to be a mysterious organ with many unknown features remaining to be elucidated, such as the pathology of hypersplenism in portal hypertension.
In this chapter, firstly, the structure and function of the spleen are explained. In addition, the pathomorphology of splenomegaly in patients with liver cirrhosis and idiopathic portal hypertension (IPH) is explained. Liver cirrhosis and IPH share the histology of chronic congestive lesions, but differences have also been reported.
Splenectomy and partial splenic embolization (PSE) to treat hypersplenism in cirrhotic patients are reviewed. Splenectomy and PSE have provided many benefits, such as improvement of hypersplenism, portal hypertension, and liver function, completion of interferon therapy and liver cancer treatment, and improvement of immunity, which may contribute to the prognosis of cirrhotic patients. Generally, splenectomy is considered to reduce immunocompetence and leads to infection susceptibility, but improvement of immunocompetence by splenectomy is rather expected in cirrhotic patients.
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