Negative Splenic Angiography in Blunt Trauma: Does Embolization Affect Splenic Salvage?
Authors
Rachel Yoo, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
Davin Evanson
Michael Gaziano
Alison Muller, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
Anthony Martin, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
Nikunj Chauhan, Department of Interventional Radiology, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
Christopher Butts, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
Vicente Cortes, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
Eugene Reilly, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
Peter K Bamberger, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
Thomas A Geng, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
Adrian Ong, Division of Acute Care Surgery/Trauma, Department of Surgery, 6823Reading Hospital, Reading, PA, USA; 419713Tower Health System, Reading, PA, USA.Follow
Publication Date
2-15-2023
Abstract
Angioembolization in blunt splenic trauma is used to maximize splenic preservation. Superiority of prophylactic embolization over expectant management in patients with a negative splenic angiography (SA) is debated. We hypothesized that embolization in negative SA would be associated with splenic salvage. Of 83 patients undergoing SA, 30 (36%) had a negative SA. Embolization was performed in 23 (77%). Grade of injury, contrast extravasation (CE) on computed tomography (CT) or embolization were not associated with splenectomy. In 20 patients with either a high-grade injury or CE on CT, 17 (85%) underwent embolization with a failure rate of 24%. In the remaining 10 without high-risk features, 6 underwent embolization with a 0% splenectomy rate. Despite embolization, the failure rate of nonoperative management (NOM) remains significant in those with high-grade injury or CE on CT. A low threshold for early splenectomy after prophylactic embolization is needed.
Publication Title
The American surgeon
First Page
31348231157863
Recommended Citation
Yoo, R., Evanson, D., Gaziano, M., Muller, A., Martin, A., Chauhan, N., Butts, C., Cortes, V., Reilly, E., Bamberger, P., Geng, T., & Ong, A.
(2023). Negative Splenic Angiography in Blunt Trauma: Does Embolization Affect Splenic Salvage?. The American surgeon, 31348231157863-31348231157863.
https://doi.org/https://doi.org/10.1177/00031348231157863
Comments
online ahead of print