• Wei-Ching Lin, Yung-Fang Chen, Chien-Heng Lin, Yuan-Hong Tzeng, Hsein-Jar Chiang, Yung-Jen Ho, Wu-Chung Shen, and Jeon-Hor Chen.
• Department of Radiology, China Medical University Hospital, No 2, Yuh-Der Road, Taichung, 40406, Taiwan, ROC.
• Acad Radiol. 2008 Feb 1;15(2):201-8.

Rationale And ObjectivesSplenic preservation is currently the trend for treatment of patients with splenic trauma to avoid complications of splenectomy. This study aimed to evaluate the feasibility of emergent transcatheter arterial embolization (TAE) for hemodynamically unstable patients with blunt splenic injury.Materials And MethodsIn a period of 2 years, 65 patients of blunt splenic trauma were studied. Patients with initial systolic blood pressure < 90 mmHg and showed initial response including rapid response and transient response to the emergent fluid resuscitation were included. Angiography and TAE was undertaken if contrast medium extravasation or pseudoaneurysm formation was noted in the computed tomography (CT) images, according to the criteria of American Association for the Surgery of Trauma. All patients who underwent TAE were admitted for observation of the possibility of delayed rupture.ResultsThirteen hemodynamically unstable patients who were responsive to initial fluid resuscitation received angiography due to abnormal CT findings including contrast agent extravasation in 12 patients, 2 patients with arteriovenous fistula, and 8 patients with pseudoaneurysm formation. TAE was successfully performed in all of these 13 patients, including 2 patients with associated left renal injuries and 1 patient associated with bilateral internal mammary arteries injuries, without complications.ConclusionsTAE is a safe and effective procedure for treating blunt splenic injury even in hemodynamically unstable patients who responded to initial fluid resuscitation.

24 keywords...

hide…