Section of Vascular and Interventional Radiology, Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
Cardiovasc Intervent Radiol. 2010 Aug;33(4):861-5. doi: 10.1007/s00270-009-9535-5. Epub 2009 Mar 7.
Although the exact benefit of adjunctive splenic artery embolization (SAE) in the nonoperative management (NOM) of patients with blunt splenic trauma has been debated, the role of transcatheter embolization in delayed splenic hemorrhage is rarely addressed. The purpose of this study was to evaluate the effectiveness of SAE in the management of patients who presented at least 3 days after initial splenic trauma with delayed hemorrhage. During a 24-month period 4 patients (all male; ages 19-49 years) presented with acute onset of pain 5-70 days after blunt trauma to the left upper quadrant. Two had known splenic injuries that had been managed nonoperatively. All had computed axial tomography evidence of active splenic hemorrhage or false aneurysm on representation. All underwent successful SAE. Follow-up ranged from 28 to 370 days. These cases and a review of the literature indicate that SAE is safe and effective for NOM failure caused by delayed manifestations of splenic arterial injury.
尽管辅助性脾动脉栓塞术（SAE）在钝性脾外伤的非手术治疗（NOM）中的确切益处存在争议，但经导管栓塞术在延迟性脾出血中的作用很少被提及。本研究的目的是评估 SAE 在治疗至少在初始脾外伤后 3 天出现延迟性出血的患者中的有效性。在 24 个月的时间内，4 名患者（均为男性；年龄 19-49 岁）在左上象限钝性创伤后 5-70 天出现急性疼痛。其中 2 人已知脾损伤已通过非手术治疗。所有患者均有计算机轴向断层扫描（CT）证据表明有活动性脾出血或假性动脉瘤。所有患者均成功进行了 SAE。随访时间为 28 至 370 天。这些病例和文献复习表明，SAE 对于因脾动脉损伤的延迟表现引起的 NOM 失败是安全有效的。
