الفهرس 
Introduction & aim of the worOnly 14 pages are availabe for public view
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Abstract
Hypersplenism is a pathologic condition seen in many disorders, the most common is liver cirrhosis with portal hypertension. It is characterized by increased pooling or destruction of the corpuscular elements of the blood by the spleen.
Splenectomy is the preferred treatment procedure in patients with hypersplenism, whereas in cases of secondary hypersplenism therapy should be directed to the underlying pathology. With awareness of the role and importance of the spleen in the immune system, conservative methods have gained prominence in the treatment of benign conditions of the spleen.
Splenic interventions as RFA and PSE are increasingly performed to treat various clinical conditions, including abdominal trauma, hypersplenism, splenic arterial aneurysm, blood diseases, portal hypertension, and splenic neoplasm. When clinically appropriate, these procedures may provide an alternative to open surgery. They may help to salvage splenic function in patients with posttraumatic injuries or hypersplenism and to improve hematologic parameters in those who otherwise would be unable to undergo high-dose chemotherapy or immunosuppressive therapy.
PSE is the most commonly used interventional method for treatment of hypersplenism. It is done by injection of embolic material to occlude the artery either proximal or distal to produce ischemic changes of the hypersplenic tissues but serious complications may be produced as splenic abscess, rupture, and post embolization syndrome.
RFA has been widely used to treat tumors of solid organs. Recent advancement of RF equipment has extended its utility to such splenic conditions as metastases of colonic and renal malignancies, hypersplenism, splenic injury, and partial splenectomy. Previous animal experiments confirm that RFA is a safe and feasible treatment for splenomegaly. In current studies , RFA is used to treat hypersplenism due to various disorders especially liver cirrhosis with portal hypertension. It is done either laparoscopic, intraoperative or percutaneous through US guidance. It exerts its effect via thermal ablation and coagulative necrosis of the splenic tissues.
In comparing with PSE on hypersplenism, both procedures have similar therapeutic principles. However, RFA has significant advantages, such as more confined lesion, less frequent and milder complications, convenient performance, and cheaper equipment requirements. This study demonstrates that RFA is a promising therapeutic approach for patients with hypersplenism.
Conclusion:
PSE and RFA procedures have similar therapeutic principles. However, RFA has more significant advantages, less complications and short hospital stay. Further studies are required to fully elucidate the role of radiofrequency ablation of the spleen and to determine how best therapeutic benefit can be obtained with minimal ablation of splenic tissue in the management of hypersplenism.