2019 Volume 39 Issue 7 Pages 1191-1194
An 8-year-old girl fell and hit the left side of her chest on a log at a recreational facility. She was transported to our hospital by ambulance complaining of pain on the left side of her chest. Contrast-enhanced abdominal computed tomography (CT) indicated type Ⅲb splenic injury, as defined by the Japanese Association for the Surgery of Trauma Spleen Damage Classification 2008, and intra-abdominal hemorrhage. No external leakage of contrast medium was noted, and the hemodynamics was stable; therefore, we selected non-operative management (NOM). The hemodynamics remained stable throughout the patient’s hospitalization. Follow-up abdominal CT on the 7th hospital day showed splenic pseudo-aneurysms as evidence of splenic injury. Transcatheter arterial embolization was performed, and the patient was discharged on the 12th hospital day, with a two-month exercise restriction. The developmental mechanism and natural course of splenic pseudoaneurysms remain unclear; thus, continued accumulation of splenic trauma cases is necessary.
