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Review
. 2023 Aug 11;9(3):149-155.
doi: 10.22575/interventionalradiology.2022-0003. eCollection 2024 Nov 1.

The Management of Splenic Injuries

Yutaka Koide  1 , Takuya Okada  2 , Masato Yamaguchi  2 , Koji Sugimoto  2 , Takamichi Murakami  2
Affiliations
Review

The Management of Splenic Injuries

Yutaka Koide et al. Interv Radiol (Higashimatsuyama). .

Abstract

Splenic injury is one of the most common abdominal parenchymal organ injuries. Since the spleen is a parenchymal organ with abundant blood flow, its injury can easily result in hemorrhagic shock. Therefore, prompt and appropriate management for hemostasis is critical. Management of splenic injury is determined by the hemodynamic status and the grade of injury. Splenectomy is the primary choice in cases with unstable hemodynamics, but splenic repair or non-operative management, including conservative treatment or transcatheter arterial embolization (TAE), may be chosen to preserve the spleen if time permits. Non-operative management has advantages over operative management in terms of complications and medical economics. TAE also plays a significant role in non-operative management by contributing to the improvement of patient outcomes.

Keywords: non-operative management; splenic arterial embolization; splenic injury.

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Conflict of interest statement

None

Figures

Figure 1.
Figure 1.
Splenic injury in a 52-year-old woman who was struck by a car. A, B: CT scan obtained at admission showing a grade 3 splenic injury with contrast media extravasation (arrow). C: Angiographic study demonstrating extravasation of the inferior polar branch of the splenic artery (arrow). D: After selective embolization with gelatin sponges and NBCA glue, the post-embolization radiograph shows no contrast media extravasation.
Figure 2.
Figure 2.
Delayed splenic pseudoaneurysm after a splenic injury in a 46-year-old man (A) and a 62-year-old man (B). A: A CT scan 3 days after admission showed a pseudoaneurysm, but the diameter of the pseudoaneurysm was small (<10 mm), and a decision was made to follow-up rather than treat the aneurysm (arrow). A CT scan 9 days after admission confirmed spontaneous resolution of the pseudoaneurysm. B: Six days after admission, a CT scan showed a large pseudoaneurysm (>10 mm diameter) (arrow), and TAE was performed. No delayed rupture occurred.
See this image and copyright information in PMC

References

    1. American College of Surgeons' Committee on Trauma. Advanced Trauma Life SupportⓇ (ATLSⓇ) Student manual 9th ed. Chicago: American College of Surgeons; 2012. doi: 10.1097/TA.0b013e31828b82f5.
    1. Kozar RA, Crandall M, Shanmuganathan K, et al. Organ injury scaling 2018 update: Spleen, liver, and kidney. J Trauma Acute Care Surg. 2018; 85: 1119-1112. - PubMed
    1. Tinkoff G, Esposito TJ, Reed J, et al. American Association for the Surgery of Trauma Organ Injury Scale I: Spleen, liver, and kidney, validation based on the National Trauma Data Bank. J Am Coll Surg. 2008; 207: 646-655. - PubMed
    1. Cohn SM, Arango JI, Myers JG, et al. Computed tomography grading systems poorly predict the need for intervention after spleen and liver injuries. Am Surg. 2009; 75: 133-139. - PubMed
    1. Sutyak JP, Chiu WC, D'Amelio LF, et al. Computed tomography is inaccurate in estimating the severity of adult splenic injury. J Trauma. 1995; 39: 514-518. - PubMed