[A serious late complication of non-operative management of splenic trauma: rupture of splenic artery aneurysm].
Over the last five past years, three patients required urgent operation in our institution for hemorrhagic shock after rupture of a post-traumatic splenic artery aneurysm. Those patients had undergone non- operative management (NOM) of grade III, IV (AAST classification) splenic injury 9, 13, and 22 months earlier. Two of them had a CT scan 30 days after initial trauma with no evidence of a developing splenic artery aneurysm. All three patients survived after proximal ligature of splenic artery and hemostatic splenectomy. Our experience with these three cases suggests that a delayed follow-up for patients at high risk is indicated in order to prevent this dramatic complication by early intervention. The modality of this follow-up should be determined by a prospective multicenter study.
Kourabi
M
M
Service de chirurgie générale et urgences, Hôpital central, CHU de Nancy - Nancy.
Reibel
N
N
Perez
M
M
Grosdidier
G
G
D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography; D004630:Emergencies; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries*; D013156:Splenectomy; D013157:Splenic Artery / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications* / Q000628:therapy