[Early embolization in the non-operative management of blunt splenic injuries: a retrospective multicenter study].
OBJECTIVE
Splenic artery embolization has been used as an adjunct to the non-surgical management of blunt splenic injury. No consensus on its indications has emerged from the literature. This multicentric study aimed to evaluate the results of this technique in France.


METHODS
Between March 2000 and April 2006, 22 patients older than 15 years of age (mean age 29, range: 15-59) with splenicv rupture due to blunt trauma underwent splenic artery embolization in six Level I Trauma Centers in France. Splenic rupture was classified Moore II in 3 cases, Moore III in 12 cases, and Moore IV in 7 cases. Angiography was performed within 4 hours of admission in half of the cases. The main indications for splenic artery embolization were: extravasation of contrast medium on CT scan (10 cases, 45%); early pseudo-aneurysm (6 cases, 23%); hypotension despite fluid resuscitation and/or progressive need for transfusion (5 cases, 22%).


RESULTS
There was no mortality. Nine patients experienced complications (41%) including 6 (27%) who developed left pleural effusion. Two patients eventually underwent splenectomy (one for persistent hemorrhage, one for splenic necrosis). The overall splenic salvage rate was 91%.


CONCLUSIONS
Splenic artery embolization is a valuable techniche that hels to lower the rate of splenectomy for traumatic splenic rupture with relatively low morbidity.
Brugère
C
C
Département de chirurgie digestive et de l'urgence, CHU de Grenoble - Grenoble.
Arvieux
C
C
Dubuisson
V
V
Guillon
F
F
Sengel
C
C
Bricault
I
I
Regimbeau
J-M
JM
Pilleul
F
F
Menegaux
F
F
Letoublon
C
C
D000293:Adolescent; D000328:Adult; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013154:Spleen / Q000293:injuries*; D013157:Splenic Artery / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000628:therapy*