Massive intraperitoneal hemorrhage from traumatic intrasplenic pseudoaneurysms: treatment using superselective...

Area of Science:

• Trauma surgery
• Interventional radiology
• Hepatology

Background:

• Splenic preservation is crucial in trauma management.
• Transcatheter embolotherapy is an emerging alternative to splenectomy for splenic hemorrhage.
• Controversy exists regarding the optimal management of splenic trauma.

Observation:

• A 41-year-old male with hepatitis C, alcoholic liver disease, and portal hypertension experienced splenic rupture from blunt force.
• The patient presented with ongoing intra-abdominal hemorrhage.
• Standard management options were considered.

Findings:

• Superselective embolotherapy was performed using microcoils and gelatin sponge.
• The procedure successfully controlled the intra-abdominal hemorrhage.
• This minimally invasive approach avoided the need for splenectomy.

Implications:

• Transcatheter embolotherapy is a viable option for managing splenic rupture, even in complex cases with comorbidities.
• This technique supports splenic preservation, potentially reducing long-term complications associated with splenectomy.
• Further research may solidify embolotherapy's role in splenic trauma protocols.