title: Role of splenic artery embolization in management of traumatic splenic injuries: a prospective study.
abstract: The objective of our study was to evaluate the role of splenic artery embolization (SAE) in the management of traumatic splenic injuries. From September 2008 to September 2010, a total of 67 patients underwent nonoperative management (NOM) for blunt splenic injuries. Twenty-two patients were excluded from the study because of associated significant other organ injuries. Twenty-five patients underwent SAE followed by NOM (group A) and 20 patients underwent standard NOM (group B). Improvement in clinical and laboratory parameters during hospital stay were compared between two groups using Chi-square test and Mann-Whitney test. SAE was always technically feasible. The mean length of the total hospital stay was lower in the group A patients (5.4 vs. 6.6 day, [P = 0.050]). There was significant increase in hemoglobin and hematocrit levels and systolic blood pressure (SBP) in group A patients after SAE, whereas in group B patients there was decrease in hemoglobin and hematocrit levels and only slight increase in SBP (pre- and early posttreatment relative change in hemoglobin [P = 0.002], hematocrit [P = 0.001], and SBP [P = 0.017]). Secondary splenectomy rate was lower in group A (4 % [1/25] vs. 15 % [3/20] [P = 0.309]). No procedure-related complications were encountered during the hospital stay and follow-up. Minor complications of pleural effusion, fever, pain, and insignificant splenic infarct noted in 9 (36 %) patients. SAE is a technically feasible, safe, and effective method in the management of splenic injuries. Use of SAE as an adjunct to NOM of splenic injuries results improvement in hemoglobin, hematocrit levels, and SBP. SAE also reduces secondary splenectomy rate and hospital stay.
authors.affiliation: Department of Radiology, JPNA Trauma centre, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India.
authors.forename: Mohan Lal
authors.initials: ML
authors.lastname: Parihar
authors.affiliation: Department of Radiology, JPNA Trauma centre, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India.
authors.forename: Atin
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Radiology, JPNA Trauma centre, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India.
authors.forename: Shivanand
authors.initials: S
authors.lastname: Gamanagatti
authors.affiliation: Department of Radiology, JPNA Trauma centre, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India.
authors.forename: Ashu Seith
authors.initials: AS
authors.lastname: Bhalla
authors.affiliation: Department of Surgery, JPNA Trauma centre, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India.
authors.forename: Biplab
authors.initials: B
authors.lastname: Mishra
authors.affiliation: Department of Surgery, JPNA Trauma centre, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India.
authors.forename: Subodh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Radiology, JPNA Trauma centre, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India.
authors.forename: Manisha
authors.initials: M
authors.lastname: Jana
authors.affiliation: Department of Surgery, JPNA Trauma centre, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India.
authors.forename: Mahesh C
authors.initials: MC
authors.lastname: Misra
keywords: Splenic artery embolisation; Trauma