Percutaneous injection therapy for blunt splenic trauma guided by contrast-enhanced ultrasonography.
OBJECTIVE
The purpose of this study was to investigate the application of contrast-enhanced ultrasonography (CEUS) in managing blunt splenic trauma and the effectiveness of CEUS-guided percutaneous injection therapy.


METHODS
Six patients with grade 3 or 4 splenic injuries as determined by CEUS and contrast-enhanced computed tomography were given hemocoagulase atrox and absorbable cyanoacrylate percutaneously, which were injected into the injury region and active bleeding site, respectively, under CEUS guidance. Immediately after the procedure and 1 and 3 days, 1 and 2 weeks, and 1 and 6 months after the procedure, follow-up CEUS up was performed in all patients.


RESULTS
Among the 6 patients, 4 cases of CEUS-guided hemostatic injection were successful without complications. Rehemorrhage occurred in 1 patient, and a traumatic arteriovenous fistula occurred in another; repeated injection therapy in these 2 patients was effective. During the follow-up, there were no complications, and spleen perfusion recovered gradually.


CONCLUSIONS
Contrast-enhanced ultrasonography can be used to guide percutaneous injection therapy and therefore achieve the goal of using interventional ultrasonography in managing splenic trauma.
Tang
Jie
J
Department of Ultrasound, Chinese People's Liberation Army General Hospital, 28 Fuxing Rd, 100853 Beijing, China. txiner@vip.sina.com
Zhang
Huiqin
H
Lv
Faqin
F
Li
Wenxiu
W
Luo
Yukun
Y
Wang
Yuexiang
Y
Li
Junlai
J
D000293:Adolescent; D000328:Adult; D012103:Batroxobin / Q000008:administration & dosage; D003287:Contrast Media; D003487:Cyanoacrylates / Q000008:administration & dosage; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D010743:Phospholipids; D011446:Prospective Studies; D013154:Spleen / Q000293:injuries*; D013459:Sulfur Hexafluoride; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000188:drug therapy*
D003287:Contrast Media; D003487:Cyanoacrylates; D006490:Hemostatics; D010743:Phospholipids; C420843:contrast agent BR1; D012103:Batroxobin; D013459:Sulfur Hexafluoride