A Case of Delayed Splenic Rupture After Transcatheter Arterial Embolizaetion for Splenic Injury

Tomohisa Egawa, Atsushi Nagashima, Mitsuhide Kitano, Masakazu Doi, Shinobu Hayashi, Masatoshi Motegi, Hiroshi Yoshii and Shuuzo Yamamoto

Department of Surgery, Saiseikai Kanagawaken Hospital

We report a case of delayed splenic rupture 5 days after transcatheter arterial embolization (TAE). A 23-year-old woman came to our emergency center with trauma to the left side of the abdomen. She was diagnosed with splenic injury type IIIc by abdominal computed tomography (CT). She was treated with selective TAE after angiography of the splenic artery showed extravasation. Following treatment, extravasation apparently disappeared. Five days after TAE, however, she reported acute abdominal pain diagnosed as dalayed splenic rupture after abdominal CT showed extravasation and abdominal bleeding. Emergency surgery was conducted for continuing hypovolemic shock and the spleen partially resected because injury was limited to the upper spleen. Following the surgery, the patient recovered uneventfully and was discharged after 19 days. It is thus important to consider delayed splenic rupture in patients diagnosed with splenic injury, even if the patient is treated with TAE.

Key words
splenic injury, delayed rupture, spleen preserving therapy

Reprint requests
Tomohisa Egawa Department of Surgery, Saiaeikai Kanagawaken Hospital 6-6 Tomiya-cho, Kanagawa-ku, Yokohama, 221-0821 JAPAN

Accepted
April 25, 2001

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