2020 Volume 56 Issue 1 Pages 53-58
Purpose: We have been actively carrying out transcatheter arterial embolization (AE) in children suffering from traumatic splenic injury associated with extravasation and pseudoaneurysms. Many patients could be successfully managed with conservative treatment by AE.
Method: From January 2001 to December 2016, 13 patients aged younger than 15 years were transferred to the emergency room of our institute because of traumatic splenic injury. They comprised eight boys and five girls, and their median age was 9 years (age range: 3–14 years). Eight patients had only splenic injury, and the rest had multiple organ injuries. Their clinical data were investigated.
Results: On the basis of the 2008 diagnostic criteria by the Japanese Association for Surgery of Trauma, the severity of one patient was categorized into Ib, four patients into IIIa, and eight patients into IIIb. Three patients (IIIb) required laparotomy. Six patients underwent angiography; three of them (extravasation, 2; pseudoaneurysm, 1) were treated by AE. In all the patients, bleeding was successfully controlled and managed conservatively except for those who required laparotomy.
Conclusion: Even when patients have splenic injuries with extravasation and pseudoaneurysms, AE enables the control of bleeding and the treatment of patients without surgery.