Keywords
Splenic injury
Embolization
Interventional radiology
NOM
How to Cite
Abstract
Introduction: The most frequent solid organ injury in blunt abdominal trauma (BAT) is splenic injury, and it is typically a result of road traffic accidents or falls. While operative management was the standard practice, the trend today is increasingly towards nonoperative management (NOM), including in hemodynamically stable patients with even moderate-to-high-grade injuries. This shift has been facilitated through advances in interventional radiology and imaging that have played a pivotal role in expanding the indications for NOM, keeping medical personnel familiarized and up-to-date.
Case presentation: Here, we report a case of a 21-year-old male with Grade III+ splenic injury with moderate-to-large hemoperitoneum following a road traffic accident on a motorcycle. After initial resuscitation, the patient remained a transient responder. CT with IV contrast showed no indication of ongoing bleeding. With a progressive hemoglobin drop in the background, the patient was successfully treated by selective splenic artery embolization in a private institution, reaffirming the efficacy of the intervention. The patient recovered completely without any requirement for surgery and was discharged on the seventh day.
Conclusion: Selective splenic embolization is an effective and safe adjuvant to NOM in high-grade splenic injuries with transient responders, reducing requirements for splenectomy and preserving immunologic function.
References
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