Preserving the spleen of a child in hemorrhagic shock due to splenic injury by damage control surgery and  transcatheter arterial embolization: A case report

Abstract

A 7-year-old girl was brought to our institution with hemorrhagic shock state caused by a fall from height. We made a diagnosis intra-abdominal hemorrhage. First, emergency laparotomy and damage control surgery (DCS) with spleen suture, gauze-packing and open abdominal management for the splenic injury were performed in our emergency room. Next, proximal splenic angioembolization with gelatin sponge was performed and then the patient escaped from the hemorrhagic shock. After craniotomy for depression and typical abdominal closure were performed, the patient was transferred to a pediatric intensive care unit in other hospital. After that, the patient was transferred for rehabilitation. Emergency laparotomy and DCS were required for hemorrhagic shock case due to intra-abdominal hemorrhage. In the case of hemorrhage caused with splenic injury, splenectomy is often performed, but overwhelming post-splenectomy infection is of great concern to children. In this case, lifesaving and splenic salvage were achieved by adding SAE to DCS.