• Akpofure Peter Ekeh, Brent Izu, Mark Ryan, and Mary C McCarthy.
• Department of Surgery, Division of Trauma, Critical Care and Emergency Surgery, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA. peter.ekeh@wright.edu
• Am. J. Surg. 2009 Mar 1;197(3):337-41.

BackgroundSplenic artery embolization (SAE) is an adjunct to nonoperative management (NOM) of splenic injuries. We reviewed our experience with SAE to identify its impact on splenic operations.MethodsPatients admitted with splenic injuries over an 8-year period were identified and the initial method of management noted (simple observation, SAE, or splenic surgery). The first 4 years (period 1) during which SAE was introduced was compared with the latter 4 years (period 2) when it was used frequently.ResultsThere were 304 patients in period 1 and 416 in period 2. NOM was initial management in 59.9% in period 1% and 60.1% in period 2 (P = 1.0) and failure rates were 5.3% versus 2.9%, respectively (P = .12). More SAE procedures were performed in period 2 -- 13.7% versus 4.9% (P < or = .001) -- and there was a reduction in the proportion of splenic operations -- 35.2% versus 26.2% (P <.01).ConclusionsSAE is associated with a reduction in splenic operations, although it did not alter the failure rate of NOM.

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