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CT detection of iatrogenic percutaneous splenic injury
Insights
Splenic injury, though rare, can occur after procedures like thoracentesis. Computed tomography identified splenic hemorrhage in three patients, highlighting the need for vigilance in patients undergoing lower chest and upper abdominal interventions.
Area of Science:
- Medical Imaging
- Interventional Radiology
- Surgical Complications
Background:
- Left-sided thoracentesis and percutaneous renal biopsy carry a known risk of splenic injury.
- Reported cases of splenic injury following these procedures are infrequent.
Observation:
- Computed tomography (CT) was utilized to monitor patients undergoing percutaneous diagnostic and therapeutic procedures.
- Over a one-year period, CT detected splenic, perisplenic, and intraperitoneal hemorrhage in three patients.
Findings:
- One patient remained asymptomatic despite evidence of hemorrhage.
- Another patient presented with left upper quadrant pain.
- A third patient experienced severe hemorrhage necessitating an emergency splenectomy.
Implications:
- This study underscores the importance of considering splenic injury in patients experiencing symptoms post-procedure.
- CT imaging is crucial for diagnosing and assessing the severity of splenic and related hemorrhages.
- Awareness of this complication is vital for clinicians performing lower chest and upper abdominal percutaneous interventions.
Abstract:
Although the potential for splenic injury during left sided thoracentesis or percutaneous renal biopsy is well known, its occurrence has been rarely reported. In a 1 year period we used computed tomography to detect acute splenic, perisplenic, and intraperitoneal hemorrhage in three patients after percutaneous diagnostic and therapeutic procedures in the lower chest and upper abdomen. One patient was asymptomatic, the second developed left upper quadrant pain, and the third required emergency splenectomy.