Negative Splenic Angiography in Blunt Trauma: Does Embolization Affect Splenic Salvage?

Authors

Rachel Yoo, Division of Acute Care Surgery/Trauma, Department of Surgery, Reading Hospital, Reading, PA, USA; Tower Health System, Reading, PA, USA.Follow
Davin Evanson
Michael Gaziano
Alison Muller, Division of Acute Care Surgery/Trauma, Department of Surgery, Reading Hospital, Reading, PA, USA; Tower Health System, Reading, PA, USA.Follow
Anthony Martin, Division of Acute Care Surgery/Trauma, Department of Surgery, Reading Hospital, Reading, PA, USA; Tower Health System, Reading, PA, USA.Follow
Nikunj Chauhan
Christopher Butts, Division of Acute Care Surgery/Trauma, Department of Surgery, Reading Hospital, Reading, PA, USA; Tower Health System, Reading, PA, USA.Follow
Vicente Cortes, Division of Acute Care Surgery/Trauma, Department of Surgery, Reading Hospital, Reading, PA, USA; Tower Health System, Reading, PA, USA.Follow
Eugene Reilly, Division of Acute Care Surgery/Trauma, Department of Surgery, Reading Hospital, Reading, PA, USA; Tower Health System, Reading, PA, USA.Follow
Kurt Bamberger, Division of Acute Care Surgery/Trauma, Department of Surgery, Reading Hospital, Reading, PA, USA; Tower Health System, Reading, PA, USA.Follow
Thomas A Geng, Division of Acute Care Surgery/Trauma, Department of Surgery, Reading Hospital, Reading, PA, USA; Tower Health System, Reading, PA, USA.Follow
Adrian Ong, Division of Acute Care Surgery/Trauma, Department of Surgery, Reading Hospital, Reading, PA, USA; Tower Health System, Reading, PA, USA.Follow

Document Type

Article

Publication Date

7-1-2023

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

Volume

89

Issue

7

First Page

3209

Last Page

3211

Recommended Citation

Yoo, R., Evanson, D., Gaziano, M., Muller, A., Martin, A., Chauhan, N., Butts, C., Cortes, V., Reilly, E., Bamberger, K., Geng, T., & Ong, A. (2023). Negative Splenic Angiography in Blunt Trauma: Does Embolization Affect Splenic Salvage?. The American surgeon, 89 (7), 3209-3211. https://doi.org/https://doi.org/10.1177/00031348231157863