CT findings after embolization for blunt splenic trauma.
OBJECTIVE
To determine complications after transcatheter embolization for blunt splenic injury as recognized with computed tomography (CT).


METHODS
From March 1997 to January 2000, 80 patients underwent transcatheter embolization after blunt splenic injury, of whom 53 underwent abdominal CT examination before and after embolization. Preembolization CT scans were reviewed to determine grade of injury, and postembolization CT scans were reviewed to identify complications secondary to embolization. Arteriography results were reviewed to determine findings and method and location of embolization.


RESULTS
Splenic infarcts occurred in 63% of patients after proximal embolization and in 100% of patients after distal embolization. Infarcts after distal embolization tend to be larger and occur just distal to the embolization material, whereas infarcts after proximal embolization tend to be smaller, multiple, and located in the periphery. Most infarcts resolved without sequelae. Seven patients developed gas within an infarct or subcapsular fluid collection. Two collections were drained and found to be sterile and one patient had a splenic abscess at laparotomy.


CONCLUSIONS
Infarcts are common after splenic embolization. Gas may be present within an infarct after embolization with Gelfoam; however, the presence of air/fluid level is a better predictor of abscess.
Department of Diagnostic Radiology, University of Maryland Medical System and Shock Trauma Center, Baltimore 21201-1595, USA.
K L
KL
Killeen
K
K
Shanmuganathan
R
R
Boyd-Kranis
T M
TM
Scalea
S E
SE
Mirvis
D000328:Adult; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D005740:Gases; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D013154:Spleen / Q000293:injuries*; D013157:Splenic Artery / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000628:therapy*
D005740:Gases