Factors affecting clinical outcome of patients who undergo transcatheter arterial embolisation in splenic injury

Sekikawa, Zenjiro; Takebayashi, Seiji; Kurihara, Hideyuki; Lee, J; Niwa, Takashi; Kawamoto, Masahiko; Yamamoto, Tomonori; Suzuki, Jirô; Sugiyama, M.; Inoue, Takeshi

doi:10.1259/bjr/21985061

Cited by 10 publications

(4 citation statements)

References 18 publications

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“…Increasingly adopted to manage traumatic splenic injuries, interventional treatment with transcatheter arterial embolisation (TAE) may also prove a valuable non-surgical option for ASR (Fig. 3 ), particularly in cases associated with anticoagulation, malaria, and mononucleosis, and when CT detects active arterial bleeding [ 2 , 17 , 27 , 28 ]. In selected patients, TAE is useful as a temporary stabilising measure.…”

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confidence: 99%

Atraumatic splenic rupture, an underrated cause of acute abdomen

Tonolini

Ierardi

2016

Insights Imaging

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mentioning

confidence: 99%

Atraumatic splenic rupture, an underrated cause of acute abdomen

Tonolini

Ierardi

2016

Insights Imaging

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“…To our knowledge, this is the only case of ASR in the setting of CMML that has been treated with SAE. In general, SAE is well tolerated, with one study finding 73.1% of patients had a positive outcome with shorter hospital stays, fewer intensive care unit days, and fewer transfusions [9]. Although 8% of patients developed delayed complications (hemorrhage, splenic abscesses, and splenic pseudocysts), most patients did well [10].…”

Section: Discussionmentioning

confidence: 99%

Atraumatic Splenic Rupture due to Chronic Myelomonocytic Leukemia Treated with Partial Splenic Artery Embolization

et al. 2022

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Splenic rupture can be categorized into two groups: traumatic and atraumatic. Traumatic rupture is frequently associated with blunt abdominal trauma, while atraumatic splenic rupture (ASR) is more uncommon and has been associated with both benign and malignant hematological disorders. In general, most cases of splenic rupture are managed with splenectomy, which carries significant mortality and morbidity; more recently, splenic artery embolization (SAE) has become a mainstay of management particularly after traumatic rupture. We describe a patient with chronic myelomonocytic leukemia (CMML) who presented to the emergency department for acute abdominal pain and was found to have an ASR. He underwent partial SAE, with postoperative complications of leukocytosis and tumor lysis syndrome (TLS) requiring rasburicase and allopurinol. On follow-up in clinic 2 months post-discharge, the patient was doing well on hydroxyurea, without need for further intervention at that time. In patients with hematologic malignancies presenting with abdominal pain and splenomegaly, it is important to consider ASR as a rare, but possible complication. To our knowledge, this is the only reported patient treated with SAE in the context of ASR from CMML, demonstrating that SAE can be an effective nonoperative strategy for treatment of CMML-associated ASR. This case report also highlights postoperative complications and management in this patient population, specifically a profound leukocytosis and TLS, for which close monitoring should be performed.

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“…Partial splenic artery embolization has been highly evaluated and recommended since the 1990s as the treatment of choice for hypersplenism, splenomegaly and hemorrhagic events (Shimizu et aI., 2003;OZdogo et al, 2004;Sekikawa et al, 2004). However, Sakai (2002), Inagawa et al (2004) and Moreno (2004) found that the most hazardous complication of this procedure was inadvertent passage of embolic material to the pancreatic branches of the splenic artery causing pancreatitis.…”

Section: Discussionmentioning

confidence: 99%