Nonoperative management of pediatric splenic injury with angiographic embolization

A 12-year-old girl was admitted after a bicycle accident, and a grade 4 splenic injury was diagnosed. She became hemodynamically unstable within the first hours after arrival and remained so despite fluid resuscitation and transfusions. As an alternative to laparotomy, splenic artery embolization was performed. The patient had an uneventful recovery without the need for further transfusions. Nonoperative management of blunt splenic trauma remains the gold standard in pediatric trauma care. In hemodynamically unstable patients, splenic artery embolization should be considered as an adjunct to that strategy.