title: A rare case of splenic pseudoaneurysm in pediatric splenic blunt trauma patient: Review of diagnosis and management.
abstract: BACKGROUND
  Splenic pseudoaneurysms (SPA) are a rare but serious sequela of blunt traumatic injury to the spleen. Management of adult blunt splenic trauma is well-studied, however, in children, the management is much less well-defined.
  
  
  METHODS
  A 15 year-old male presented with severe abdominal pain of acute onset after sustaining injury to his left side while playing football. FAST was positive for free fluid in the abdomen. Initial abdomen CT demonstrated a grade III/IV left splenic laceration with moderate to large hemoperitoneum with no active extravasation or injury to the splenic vessels noted. A follow-up CT angiography of the abdomen demonstrated a splenic hypervascular structure suspicious for a small pseudoaneurysm. Splenic arteriogram which demonstrated multiple pseudoaneurysms arising from the second order splenic artery branches which was angioembolized and treated.
  
  
  CONCLUSIONS
  Questions still remain regarding the timing of repeat imaging for diagnosis of SPA following non-operative blunt splenic trauma, which patients should be imaged, and how to manage SPA upon diagnosis. More clinical study and basic science research is warranted to study the disease process of SPA in pediatric patient. We believe that our proposed management algorithm timely detect formation of delayed SPA formation and addresses the possible fatal disease course of pediatric SPA.
authors.affiliation: SUNY Downstate, College of Medicine, 450 Clarkson Ave, Brooklyn, NY 11203, United States. Electronic address: roger.zhu@downstate.edu.
authors.forename: Roger Chen
authors.initials: RC
authors.lastname: Zhu
authors.affiliation: SUNY Downstate, College of Medicine, 450 Clarkson Ave, Brooklyn, NY 11203, United States.
authors.forename: Vadim
authors.initials: V
authors.lastname: Kurbatov
authors.affiliation: SUNY Downstate, College of Medicine, 450 Clarkson Ave, Brooklyn, NY 11203, United States.
authors.forename: Patricia
authors.initials: P
authors.lastname: Leung
authors.affiliation: SUNY Downstate, College of Medicine, 450 Clarkson Ave, Brooklyn, NY 11203, United States.
authors.forename: Gainosuke
authors.initials: G
authors.lastname: Sugiyama
authors.affiliation: Department of Surgery, Kings County Hospital Center, 451 Clarkson Ave, Brooklyn, NY 11203, United States; SUNY Downstate, College of Medicine, 450 Clarkson Ave, Brooklyn, NY 11203, United States.
authors.forename: Valery
authors.initials: V
authors.lastname: Roudnitsky
keywords: Paediatric trauma; Splenic laceration; Splenic pseudoaneurysm; Splenic trauma