Transcatheter Embolization for Delayed Hemorrhage Caused by Blunt Splenic Trauma |
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Authors: | Steven J Krohmer Eric K Hoffer Kenneth W Burchard |
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Institution: | (1) Section of Vascular and Interventional Radiology, Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA;(2) Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, 03756, USA |
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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. |
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