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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Laparoscopic splenectomy following embolization for blunt trauma.
Kenneth J Ransom1, Michael S Kavic
1St. Elizabeth Health Center, Youngstown, Ohio 44501-1790, USA.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|April 26, 2008
Summary
High-grade splenic injuries treated with embolization may require surgery. Laparoscopic splenectomy can be a safe, minimally invasive option following embolization for severe spleen trauma.
Area of Science:
- Trauma surgery
- Interventional radiology
- Surgical oncology
Background:
- High-grade splenic injuries (Grade III-V) often involve hemorrhage and may fail nonoperative management.
- Angiographic embolization is effective in 50-75% of patients with high-grade splenic injury, but splenectomy may still be needed.
- Splenic infarction and abscess formation can necessitate further intervention after embolization.
Observation:
- A 15-year-old female sustained a Grade V splenic laceration with hemoperitoneum after an ATV crash.
- Central splenic artery embolization was performed due to ongoing bleeding.
- Laparoscopic splenectomy was subsequently performed due to persistent hemorrhage.
Findings:
- The patient achieved a satisfactory outcome post-surgery.
- Full recovery and return to normal activities occurred within two weeks.
Implications:
- Embolization can serve as a bridge to surgical intervention for high-grade splenic injuries.
- Laparoscopic splenectomy is a viable, less-invasive surgical option after embolization in select cases.
- This approach may improve outcomes for patients with severe splenic trauma.
