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CT findings after embolization for blunt splenic trauma.
K L Killeen1, K Shanmuganathan, R Boyd-Kranis
1Department of Diagnostic Radiology, University of Maryland Medical System and Shock Trauma Center, Baltimore 21201-1595, USA.
Journal of Vascular and Interventional Radiology : JVIR
|March 27, 2001
Summary
Transcatheter embolization for blunt splenic injury commonly causes splenic infarcts. While often resolving without issue, gas within an infarct may indicate a splenic abscess, especially if an air/fluid level is present.
Area of Science:
- Radiology
- Interventional Radiology
- Trauma Surgery
Background:
- Blunt splenic injury is a common cause of intra-abdominal bleeding.
- Transcatheter splenic artery embolization is an established treatment for hemodynamically stable patients.
- Computed tomography (CT) is crucial for diagnosing splenic injury and assessing treatment response.
Purpose of the Study:
- To evaluate complications of transcatheter embolization for blunt splenic injury.
- To correlate CT findings with embolization techniques and outcomes.
Main Methods:
- Retrospective review of 80 patients undergoing embolization for blunt splenic injury (1997-2000).
- Analysis of pre- and post-embolization CT scans in 53 patients to identify injury grade and complications.
- Review of arteriography to determine embolization method and location.
Main Results:
- Splenic infarcts were observed in 63% of patients after proximal embolization and 100% after distal embolization.
- Infarcts after distal embolization were larger and more localized; proximal embolization resulted in smaller, peripheral infarcts.
- Gas within an infarct or fluid collection occurred in 7 patients; one developed a splenic abscess.
Conclusions:
- Splenic infarcts are a frequent finding after embolization for blunt splenic injury.
- Gas within an infarct, particularly with an air/fluid level, may predict splenic abscess formation.