Traumatic splenic injury with subsequent embolization

Case contributed by RMH Core Conditions

Presentation

Motorbike collision.

Patient Data

Age: 35
Gender: Male

Contusion of the spleen with some hemorrhage demonstrated in the region around the spleen.Further blood is demonstrated around the right lobe of the liver extending into the right paracolic gutter.Some blood is also present in the dependent parts of the pelvis.The bowel is normal in caliber with no free air demonstrated within the peritoneal compartment.The kidneys are normal in appearance and opacify symmetrically. No lumbar vertebral body fracture can be identified. The pelvis appears to be intact.

CONCLUSION: There is a splenic contusion/laceration with blood demonstrated around the spleen, around the liver and in the pelvis.No definite active bleeder.

A 5 Fr sheath was inserted into the right CFA. A 5Fr Cobra was used to perform selective injections within the celiac trunk and splenic artery. There was no evidence of active extravasation or pseudoaneurysm. The splenic artery was tortuous with early bifurcation.

Endovascular therapy: A Progreat microcatheter was steered distally into the splenic artery to the bifurcation. 10 x IDC coils were deployed with good result.

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