Traumatic splenic laceration (grade IV) with splenic artery pseudoaneurysm

Case contributed by RMH Core Conditions


Car vs pole at 60 km/hr.

Patient Data

Age: 20
Gender: Male

A grade 4 splenic laceration, with several parenchymal fracture lines, is present and there is evidence of active arterial extravasation from the anterior aspect of laceration.

A moderately large amount of free intra-abdominal fluid is present.

There is no para-aortic hematoma or aortic dissection seen.No evidence of renal or hepatic laceration is seen. No definite evidence of pancreatic injury is seen. No free intra-abdominal gas is seen. There is no lumbar spine or pelvic bone fracture seen.

Midpole splenic artery pseudoaneurysm. No active bleeding at the time of angio.

Progreat microcatheter used. Pseudoaneurysm excluded with 5 of 2 x 5mm Figure-8-Pushable-0.14 coils. Main Splenic artery embolized at the hilum, using 5 of 5 x 40mm Helical-35- Pushable coils.

Case Discussion

This cases demonstrates a splenic artery pseudoaneurysm, a common complication of blunt abdominal trauma and a successful trauma splenic embolization. 

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