[Embolization of the splenic artery after splenic gunshot wound].

Abstract

Computed tomography (CT) of the abdomen is a reliable method for evaluation of spleen injuries and has the potential to exclude further abdominal injuries. Blunt and penetrating injuries of the spleen have to be managed immediately due to a high mortality rate. Two therapeutical options, conservative or operative, are currently available. In general, a hemodynamic stable patient, no further injuries of the abdominal organs or the skull as well as no history of abdominal surgery of the abdomen are prerequisites for a non-surgical therapy. Catheter-based angiography gives the possibility to diagnose and to treat injuries of blood vessels of the spleen, which were seen on the CT scans. Gunshots are relatively rare in Europe, but the mortality of such traumas is high. The present case demonstrates a patient with a penetrating gunshot trauma of the left hemiabdomen with a bleeding injury of the spleen. Due to the stable hemodynamic conditions, absence of further injuries of the abdomen or the skull and, because of previous pancreas surgery a non-surgical therapy was chosen, consisting of proximal embolisation of the splenic artery.