Splenoportography, radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Splenoportography, Radiological Supervision and Interpretation
Summary
Splenoportography is an imaging procedure that involves injecting a contrast dye into the spleen to visualize the spleen and the portal venous system. This helps in diagnosing and evaluating various conditions related to the liver, spleen, or significant bleeding disorders.
Purpose
Splenoportography is used to assess the health of the portal venous system, which carries blood from the spleen, stomach, pancreas, and intestines to the liver. It helps detect disorders like portal hypertension, splenic vein thrombosis, and other vascular abnormalities. The goal is to provide detailed images to guide further treatment or surgical decisions.
Indications
- Symptoms of portal hypertension (e.g., varices, ascites)
- Unexplained splenomegaly (enlarged spleen)
- Suspected splenic or portal vein thrombosis
- Diagnostic clarification for liver disorders
Preparation
- The patient should fast (no food or drink) for at least 6 hours before the procedure.
- Inform the doctor about any medications, allergies, or existing medical conditions.
- Blood tests and imaging studies such as an ultrasound or CT scan may be required beforehand.
Procedure Description
- The patient lies down and a local anesthetic is applied to the area around the spleen.
- A long, thin needle is inserted into the spleen under ultrasound or fluoroscopic guidance.
- Contrast dye is injected through the needle to visualize the portal venous system.
- Radiological images are taken to capture detailed views.
- The needle is removed, and a bandage is applied to the puncture site.
Advanced imaging equipment such as X-ray or fluoroscopy machines are used during the procedure.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
Splenoportography is performed in a hospital's radiology department or an outpatient imaging center.
Personnel
- Radiologist
- Radiology technician
- Nurse
Risks and Complications
- Common risks: slight pain or discomfort at the needle insertion site, bruising.
- Rare risks: infection, bleeding, injury to surrounding organs, allergic reaction to the contrast dye.
- Complications are managed with medications, close monitoring, or additional procedures if necessary.
Benefits
The main benefit is obtaining detailed images of the portal venous system, which aids in accurate diagnosis and treatment planning. Results can be available shortly after the procedure.
Recovery
- Patients are typically observed for a short period after the procedure to monitor for any immediate complications.
- Mild pain or discomfort at the injection site may be managed with over-the-counter pain relief.
- Normal activities can usually be resumed the following day, unless otherwise instructed by the physician.
Alternatives
- Doppler ultrasound: non-invasive, but less detailed imagery.
- CT or MRI scans: non-invasive but may not always provide the precise detail needed for specific vascular issues.
- Each alternative has its pros and cons, and the choice depends on the specific medical condition and patient needs.
Patient Experience
During the procedure, the patient may feel a brief pinch or pressure when the needle is inserted. They might also experience a warm sensation as the contrast dye is injected. Afterward, any discomfort is usually mild and short-lived. Pain management options and comfort measures will be provided as needed.