SELECTIVE ARTERIAL EMBOLIZATION FOR SPLENIC ARTERY PSEUDOANEURYSM IN PEDIATRIC PATIENTS WITH BLUNT SPLENIC INJURY : REPORT OF 3 CASES AND LITERATURE REVIEW

Abstract

　　Delayed hemorrhage is a serious complication of non-operative management in patients with splenic injury. Although splenic artery pseudoaneurysm has been suggested to be involved in this condition, the therapeutic approach in children is not clear. We report three cases with different clinical courses. Case 1 : No pseudoaneurysm was demonstrated at the time of admission. However, delayed bleeding occurred and pseudoaneurysm was evident on day 2 after injury, which was embolized. Case 2 : A pseudoaneurysm presented on admission was rapidly enlarged on day 3 after injury, for which embolization was performed. Case 3 : A pseudoaneurysm was diagnosed on the 8th day, which disappeared on angiography on the 13th day. Serial evaluation of vascular injury is essential in non-operative management for pediatric trauma patients with splenic injury. Selective splenic artery embolization should be considered for any pseudoaneurysm, even in pediatric trauma patients.