title: Transcatheter embolization for delayed hemorrhage caused by blunt splenic trauma.
abstract: Although the exact benefit of adjunctive splenic artery embolization (SAE) in the nonoperative management (NOM) of patients with blunt splenic trauma has been debated, the role of transcatheter embolization in delayed splenic hemorrhage is rarely addressed. The purpose of this study was to evaluate the effectiveness of SAE in the management of patients who presented at least 3 days after initial splenic trauma with delayed hemorrhage. During a 24-month period 4 patients (all male; ages 19-49 years) presented with acute onset of pain 5-70 days after blunt trauma to the left upper quadrant. Two had known splenic injuries that had been managed nonoperatively. All had computed axial tomography evidence of active splenic hemorrhage or false aneurysm on representation. All underwent successful SAE. Follow-up ranged from 28 to 370 days. These cases and a review of the literature indicate that SAE is safe and effective for NOM failure caused by delayed manifestations of splenic arterial injury.
authors.affiliation: Section of Vascular and Interventional Radiology, Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. Steven.J.Krohmer@hitchcock.org
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Krohmer
authors.forename: Eric K
authors.initials: EK
authors.lastname: Hoffer
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Burchard
mesh_terms: D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis / Q000628:therapy; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000628:therapy*; D055815:Young Adult