Literature Review of the Role of Ultrasound, Computed Tomography, and Transcatheter Arterial Embolization for the Treatment of Traumatic Splenic Injuries

Overview

Journal Cardiovasc Intervent Radiol

Specialty Cardiology & Vascular Diseases

Date 2010 Jul 30

PMID 20668852

Citations 13

Authors

Cornelis H van der Vlies

Otto M van Delden

Bastiaan J Punt

Kees J Ponsen

Jim A Reekers

J Carel Goslings

Affiliations

Soon will be listed here.

Abstract

Introduction: The spleen is the second most frequently injured organ following blunt abdominal trauma. Trends in management have changed over the years. Traditionally, laparotomy and splenectomy was the standard management. Presently, nonoperative management (NOM) of splenic injury is the most common management strategy in hemodynamically stable patients. Splenic injuries can be managed via simple observation (OBS) or with angiography and embolization (AE). Angio-embolization has shown to be a valuable alternative to observational management and has increased the success rate of nonoperative management in many series.

Diagnostics: Improved imaging techniques and advances in interventional radiology have led to a better selection of patients who are amenable to nonoperative management. Despite this, there is still a lot of debate about which patients are prone to NOM.

Angiography And Embolization: The optimal patient selection is still a matter of debate and the role of CT and angio-embolization has not yet fully evolved. We discuss the role of sonography and CT features, such as contrast extravasation, pseudoaneurysms, arteriovenous fistulas, or hemoperitoneum, to determine the optimal patient selection for angiography and embolization. We also review the efficiency, technical considerations (proximal or selective embolization), logistics, and complication rates of AE for blunt traumatic splenic injuries.

Citing Articles

Non-operative management of blunt splenic trauma: evolution, results and controversies.

Meira Junior J, Menegozzo C, Rocha M, Utiyama E Rev Col Bras Cir. 2021; 48:e20202777.

PMID: 33978122 PMC: 10683451. DOI: 10.1590/0100-6991e-20202777.

A Multiscale Deep Learning Method for Quantitative Visualization of Traumatic Hemoperitoneum at CT: Assessment of Feasibility and Comparison with Subjective Categorical Estimation.

Dreizin D, Zhou Y, Fu S, Wang Y, Li G, Champ K Radiol Artif Intell. 2020; 2(6):e190220.

PMID: 33330848 PMC: 7706875. DOI: 10.1148/ryai.2020190220.

[Interventional radiology as emergency therapy].

Armbruster M, Wirth S, Seidensticker M Radiologe. 2020; 60(3):258-268.

PMID: 31970424 DOI: 10.1007/s00117-019-00637-6.

Spontaneous Splenic Rupture following Colorectal Surgery and Hemodialysis.

AlMuhsin A, Privitera A, Balhareth A, Sabr K Case Rep Surg. 2019; 2019:8278419.

PMID: 31321113 PMC: 6610708. DOI: 10.1155/2019/8278419.

A rare case of splenobronchial fistula formation post-embolisation therapy following acute blunt trauma.

Kular S, Hoare T, Nice C BJR Case Rep. 2018; 3(2):20160100.

PMID: 30363293 PMC: 6159248. DOI: 10.1259/bjrcr.20160100.

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