Splenic abscess after splenic blunt injury angioembolization

Area of Science:

• Trauma Surgery
• Interventional Radiology
• Surgical Pathology

Background:

• Nonoperative management (NOM) with splenic angioembolization (SAE) is effective for blunt splenic injuries (BSI) grades III-V.
• SAE is a valuable tool for managing hemodynamically stable patients with BSI.
• This approach aims to preserve splenic function and avoid splenectomy.

Observation:

• A 38-year-old male presented with blunt abdominal trauma and a grade IV OIS splenic injury.
• The patient underwent NOM with SAE but developed a splenic abscess one week post-procedure.
• Histological examination revealed splenic abscesses and hemorrhagic areas, despite negative perisplenic hematoma cultures.

Findings:

• Splenic abscess is a rare but serious complication of SAE in BSI management.
• Commonly implicated organisms include Clostridium perfringens, Streptococcus, Staphylococcus, Salmonella, Candida, and Aspergillus.
• This case highlights the potential for rapid abscess development post-SAE.

Implications:

• Patients undergoing SAE for BSI require vigilant monitoring for infectious complications.
• Monitoring should extend beyond hemodynamic stability to include inflammatory and infectious markers.
• Early detection and management of splenic abscesses post-SAE are critical for patient outcomes.