2021 Volume 12 Issue 2 Pages 63-68
[Purpose] Blunt splenic trauma is primarily treated conservatively. Delayed hemorrhage is sporadically reported as a complication. We present our experience of blunt splenic trauma and discuss the management of associated pseudo aneurysms.
[Methods] Nineteen pediatric cases of blunt splenic trauma managed at our facility from 2005 to 2018 were examined. Age at the time of trauma; disease type; presence or absence of extravascular leakage, pseudoaneurysms, and multiple trauma; treatment; and outcomes were retrospectively collected from the medical records.
[Results] The median age at the time of trauma was 8.0 (4–14) years. Overall, two, three, one, and 13 patients had type I, II, IIIa, and IIIb disease, respectively. Multiple trauma and extravascular leakage were observed in four patients (21.1%). Six patients (31.6%) developed pseudoaneurysms. The treatments included nonoperative management (NOM) (14 patients [74%]), transarterial embolization (TAE) (four patients [21%]), and surgery (one patient [5%]). Regarding complications, one patient with pseudoaneurysm who underwent NOM developed delayed hemorrhage.
[Conclusion] The incidence of pseudoaneurysm due to splenic trauma is higher than that previously reported. We also observed delayed hemorrhage as a complication. We, therefore, emphasized the risk of rupture during conservative treatment and decided to perform TAE in principle for pseudoaneurysm at our hospital.
