A CASE OF GIANT LIQUEFACTION FOLLOWING TRANSCATHETER ARTERIAL EMBOLIZATION OF BLUNT SPLENIC INJURY

• Published in: Journal of the Japanese Association for the Surgery of Trauma Vol. 36; no. 1; pp. 22 - 27
• Main Authors: HIMURA, Hoshi, UCHIDA, Kenichiro, KAWATA, Sae, MATSUO, Kenji, DEGUCHI, Ryo, MIYASHITA, Masahiro, KAGA, Shinichiro, NODA, Tomohiro, NISHIMURA, Tetsuro, YAMAMOTO, Hiromasa, MIZOBATA, Yasumitsu
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Association for the Surgery of Trauma 20.01.2022
• Subjects: giant liquefaction; splenic injury; transcatheter arterial embolization
• ISSN: 1340-6264; 2188-0190
• DOI: 10.11382/jjast.36.1_05

A 50-year-old man was admitted to our hospital after a motorcycle accident. Although his vital signs demonstrated slight tachycardia, blood pressure was maintained throughout resuscitation. Since contrast enhanced abdominal CT showed extravasation of enhancement medium in the splenic injury, we decided to perform transcatheter arterial embolization to control the bleeding. The pseudoaneurysm in the splenic hilum and hemorrhage inside the injured splenic viscera were embolized using gelatin sponges. Since progressive anemia was observed, arterial coiling was added to the splenic artery on the next day. On the 27th hospital day, contrast enhanced CT demonstrated giant liquefaction. We managed the lesion with cautious observation for infection or spontaneous rupture. The size of the liquefaction got smaller on the 66th day. When no complications or concomitant symptoms are observed, giant liquefaction after splenic infarction can be treated conservatively even if the size of the liquefaction exceeds the splenic viscera.