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Nonoperative Management of Traumatic Splenic Injuries: Is There a Role for Proximal Splenic Artery Embolization?

Bertrand Bessoud1,2, Alban Denys1,2, Jean-Marie Calmes3, David Madoff4, Salah Qanadli1,2, Pierre Schnyder1,2 and Francesco Doenz1,2

1 Department of Radiology, Bicêtre Hospital, 78 rue du Général Leclerc, Le Kremlin-Bicêtre 94270, France.
2 Department of Interventional Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
3 Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
4 Present address: Division of Diagnostic Imaging, Section of Interventional Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX.


Figure 1
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  		Fig. 1A —42-year-old man with grade IV traumatic splenic injury. Axial CT images show multiple splenic lacerations extending to hilum with active contrast extravasation and hemoperitoneum.

 

Figure 2
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  		Fig. 1B —42-year-old man with grade IV traumatic splenic injury. Axial CT images show multiple splenic lacerations extending to hilum with active contrast extravasation and hemoperitoneum.

 

Figure 3
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  		Fig. 1C —42-year-old man with grade IV traumatic splenic injury. Anteroposterior splenic angiogram with 5-French catheter shows anatomy and active extravasation.

 

Figure 4
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  		Fig. 1D —42-year-old man with grade IV traumatic splenic injury. Anteroposterior view shows 0.035-inch (Tornado, Cook) coils deployed in proximal splenic artery, thereby allowing cessation of flow in arterial trunk. Small pancreatic arteries still perfuse spleen through collaterals.

 

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