Endovascular Trapping of a Giant Splenic Artery Aneurysm by Liquid Embolic in a Case of EHPVO with Hypersplenism with a Complicated Post Procedure Course.

Case of extrahepatic portovenous obstruction (EHPVO) with giant splenic artery aneurysm and concomitant hypersplenism. The presence of bicytopenia and venous collaterals around the giant splenic aneurysm made splenectomy risky, and endovascular trapping of the giant aneurysm with partial splenic embolization was planned. Due to high flow, intraprocedural crossing of the giant aneurysm was not possible, and large coils were unstable. The aneurysm was successfully embolized with liquid embolic glue: lipiodol 50% mixture. Although the patient did not have septic complications despite large splenic infarct, the patient had secondary thrombocytosis leading to significant thrombotic complications akin to postsplenectomy syndrome. These were all successfully managed medically, and splenectomy was avoided.