title: Splenic abscess after splenic blunt injury angioembolization.
abstract: BACKGROUND
  Splenic Angioembolization (SAE), during Nonoperative Management (NOM) of Blunt Splenic Injury (BSI), is an effective therapy for hemodynamically stable patients with grade III, IV, and V OIS splenic injuries. We report a case of a patient with a blunt abdominal trauma due to an accidental fall, who presented splenic abscess a week after SAE and a review of the literature.
  
  
  METHODS
  A 38-year-old male arrived at Emergency after an accidental fall with contusion of the left upper quadrant of the abdomen. Abdominal CT scan revealed the fracture of the lower splenic pole with intraparenchymal pseudoaneurysms (OIS spleen injury scale IV). Considering the hemodynamic stability, NOM was undertaken and SAE was performed. After a week, the patient developed a splenic abscess confirmed by Abdominal CT; therefore, splenectomy was performed. There was no evidence of bacterial growing in the perisplenic hematoma cultures but the histological examination showed multiple abscess and hemorrhagic areas in the spleen.
  
  
  CONCLUSIONS
  Splenic abscess after SAE during NOM of BSI is a rare major complication. The most frequently cultured organisms include Clostridium perfringens, Alpha-Hemoliticus Streptococcus, gram-positive Staphylococcus, gram-negative Salmonella, Candida, and Aspergillus. This case represents our first reported splenic abscess after SAE.
  
  
  CONCLUSIONS
  SAE is a very useful tool for BSI managing; splenic abscess can occur in a short time, even if it is a rare major complication, so it may be useful to monitor patients undergoing SAE, focusing not only on the hemodynamic parameters but also on the inflammatory and infectious aspects.
authors.forename: Dario
authors.initials: D
authors.lastname: Tartaglia
authors.forename: Christian
authors.initials: C
authors.lastname: Galatioto
authors.forename: Piero Vincenzo
authors.initials: PV
authors.lastname: Lippolis
authors.forename: Matteo
authors.initials: M
authors.lastname: Modesti
authors.forename: Desirée
authors.initials: D
authors.lastname: Gianardi
authors.forename: Andrea
authors.initials: A
authors.lastname: Bertolucci
authors.forename: Monica
authors.initials: M
authors.lastname: Cucinotta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zocco
authors.forename: Massimo
authors.initials: M
authors.lastname: Seccia
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology*; D000328:Adult; D000783:Aneurysm / Q000209:etiology* / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D006801:Humans; D008297:Male; D013154:Spleen / Q000293:injuries*; D013157:Splenic Artery; D013158:Splenic Diseases / Q000209:etiology* / Q000382:microbiology*; D014949:Wounds, Nonpenetrating / Q000150:complications*