Angiographic embolization of a post-traumatic splenic pseudoaneurysm
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207 Hellenic Journal of Surgery 2013; 85: 3
Angiographic Embolization of a Post-Traumatic Splenic Pseudoaneurysm Case Report P. Dikaiakos, N. Paschalidis, Ch. Markakis, M. Voultsos, K. Malagari, H. Moschouris, A. Marinis, S. Rizos Received 11/01/2013 Accepted 26/02/2013
Abstract After the liver, the spleen is the second most commonly injured organ in blunt abdominal trauma. The past two decades have witnessed a trend towards non-surgical management of these injuries, and transarterial embolization (TAE) has greatly contributed to avoiding unnecessary laparotomies, especially in haemodynamically stable patients. We present the case of a 21-year-old male patient involved in a motor accident with subsequent injury of the left thorax and fracture of the left ulna. Abdominal computed tomography revealed the presence of a parenchymal haematoma and a pseudoaneurysm of the splenic artery. Since the patient was haemodynamically stable, he was admitted to the clinic and the pseudoaneurysm was treated with distal selective TAE. Six months later, he remains asymptomatic without signs of pathology on Doppler ultrasound at follow-up. The use of these modalities can contribute to better success rates of NOM and should be readily available at any hospital treating trauma patients.
Key words:
Splenic trauma, Angiographic embolization, Splenic pseudoaneurysm, Embolization of splenic artery.
Introduction The spleen is a highly vascularized organ in the left upper quadrant of the abdominal cavity and the second most frequently injured organ in abdominal trauma, after the liver[1]. Motor and sport accidents, along with falls from a height are the most common causes of splenic trauma. Surgical splenic salvage procedures and non-operative management (NOM) with the aid of transarterial embolization (TAE) have been increasingly adopted in the last two decades
P. Dikaiakos (Corresponding author) - First Surgical Department, Tzaneion Hospital, Tzani 1 and Afentouli str, Piraeus, Greece K. Malagari, H. Moschouris - Radiology Department, Tzaneion Hospital, Tzani 1 and Afentouli str, Piraeus, Greece e-mail: [email protected]
owing to the significantly increased risk of sepsis in otherwise normal hosts following traditional splenectomy [2-3]. This is particularly true for haemodynamically stable patients and for those who develop rare complications like arteriovenous fistulas and pseudoaneurysms. The advances in interventional radiology and imaging techniques and the availability of these modalities in more hospitals have helped many patients who would otherwise have undergone traditional laparotomy and splenectomy. We present the case of a 21-year-old male patient who suffered a motorcycle accident, leading to splenic haematoma with subsequent development of a pseudoaneurysm, which was treated with distal selective splenic artery embolization.
Case report Written informed consent was obtained from the patient for the publication of his personal data. A 21-year-old Caucasian male patient was admitted to our emergency department after
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