Admission angiography for blunt splenic injury: advantages and pitfalls

J Trauma. 2001 Dec;51(6):1161-5. doi: 10.1097/00005373-200112000-00023.


Background: To analyze the use of admission angiography as a nonoperative adjunct for management of blunt splenic injury.

Methods: Retrospective chart review of all blunt splenic injuries to a Level I trauma center from March 1997 through July 1999.

Results: One hundred twenty-six patients underwent angiography for splenic injury. Eighty-six patients (68%) had a negative angiogram and were treated expectantly. Of these, seven patients (8%) required laparotomy, with a splenic salvage rate of 92%. Embolization was performed on 40 patients (32%) for evidence of vascular injury. Of these, three patients (8%) required laparotomy, for a total salvage of 92%. Repeat angiography was performed for suspicion of bleeding in 12 patients (10%), with 50% requiring embolization. Outcome based on CT grade demonstrated an average grade of 2.9, with a salvage rate of greater than 70% for grade IV and V injuries.

Conclusion: Vascular injury increases with splenic injury grade. Embolization improves nonoperative salvage rates to 92%, even with high-grade injuries. Ten percent of patients require additional therapy including "second-look" angiography. A significant portion of patients with negative screening angiograms (10%) required either embolization or laparotomy to control delayed hemorrhage.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Angiography / standards*
  • Embolization, Therapeutic
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Medical Records
  • Patient Admission
  • Predictive Value of Tests
  • Retrospective Studies
  • Spleen / diagnostic imaging
  • Spleen / injuries*
  • Tomography, X-Ray Computed
  • Trauma Centers
  • Treatment Outcome
  • Wounds, Nonpenetrating / diagnosis*
  • Wounds, Nonpenetrating / diagnostic imaging
  • Wounds, Nonpenetrating / therapy*