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Evaluation of results of spleen embolization in polytraumatized patients – 4year experience


Authors: Jan Kovařík 1;  Martin Kocher 2;  Igor Čižmář 1;  Ján Palčák 1
Authors‘ workplace: Oddělení traumatologie, Fakultní nemocnice Olomouc 1;  Radiologická klinika, Fakultní nemocnice Olomouc 2
Published in: Úraz chir. 21., 2013, č.1

Overview

INTRODUCTION:
Conservative treatment of blunt injury to the spleen is now the standard for hemodynamically stable patients after abdominal injury. Acute splenic embolization increases the probability of success of conservative treatment.

METHODS:
Evaluation of the results of a group of patients with blunt splenic injuries treated by embolization at Traumacentre FN Olomouc in the period 01/08 to 01/12. Analysis of demographic data, type of embolization technique, degree of splenic injury and frequency and severity of complications.

RESULTS:
The group consisted of 9 patients with a mean age of 37.3 years. Average degree of injury to the spleen by AAST was 2.8. All patients with active bleeding on CT examination were indicated for angioembolization. All patients underwent distal embolization. No patient was converted to surgical treatment. The overall incidence of complications was 66.6 %. Of these, one complication was evaluated as severe and consisted of renal failure after contrast administration with the need for intermittent dialysis. Mild complications included fluidothorax 2x (1x with the need to puncture), 2x presence of fever without identified source of infection, 1x splenic artery dissection by coil (subsequent course was without consequences).

CONCLUSION:
Embolization is a safe and effective technique improving the results of conservative therapy and replacing the previously widely used splenectomy.

Key words:
embolization, splenic trauma, complications.


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