Abstract
In blunt splenic trauma, nonsurgical therapy including selective transcatheter arterial embolization (TAE) is treatment of choice. Late bleeding and delayed onset of splenic rupture are known complications of nonsurgical therapies. We experienced a case of an arteriovenous splenic fistula which occurred during hospital care after TAE for blunt splenic trauma and demanded repeated TAE. The case involved a 43-year-old woman who was brought into our hospital after she got a bruise on the left lateral region of chest at an automobile accident in September 2011. Abdominal contrast-enhanced CT scan revealed splenic rupture and intra-abdominal bleeding. Following selective celiac arteriography, the lower pole branch of the splenic artery was occluded by using micro coil. Abdominal CT scan performed on the eighth hospital day showed two pseudo-aneurysms, for which we selected observation of the clinical course because spontaneous disappearance could be expected. We performed 3D-CT on the 15th hospital day and found that one of two pseudo-aneurysms had disappeared but the other was kept intact which was diagnosed as traumatic arteriovenous splenic fistula. Another TAE was performed. The patient's postoperative course was satisfactory and she was discharged from the hospital on the 20th hospital day.
