Diffuse traumatic splenic arterial pseudoaneurysms

Case contributed by Dr Chris Newman

Presentation

Found on side of road following motorbike accident.

Patient Data

Age: 50 years
Gender: Male
  • small volume hemoperitoneum centered within the left upper quadrant and pelvis
  • heterogenous enhancement of the spleen with lobulated, serpiginous and hyperenhancing foci interposed between regions of hypoattenuation
  • no other abnormality within the abdomen
DSA (angiography)
  • DSA confirms the presence of multiple splenic pseudoaneurysms¬†
  • proximal splenic arterial coil embolization performed demonstrating stagnant contrast after the embolization

Case Discussion

Isolated diffuse splenic arterial pseudoaneurysm formation following left-sided trauma.

This case illustrates the benefit of dual-bolus trauma studies as the spleen should normally enhance homogeneously using the dual-bolus method. The spleen commonly enhances heterogeneously on arterial phase studies in particular.

The hemoperitoneum supported the concern for splenic injury in this case however the extent of pseudoaneurysm formation is a little unusual given the lack of trauma elsewhere.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.