Complications arising from splenic embolization after blunt splenic trauma

Am J Surg. 2005 Mar;189(3):335-9. doi: 10.1016/j.amjsurg.2004.11.033.


Background: Nonoperative management (NOM) of splenic trauma is now the standard in stable trauma patients. Splenic artery embolization (SAE) is an increasingly used adjunct to NOM. We examined complications arising from SAE.

Methods: Patients admitted to a level I trauma center with splenic trauma over a 26-month period were identified. Management method, operative or nonoperative, was noted. SAE patients were analyzed in detail.

Results: There were 284 splenic trauma admissions. Ninety-three patients underwent operative management, and 191 received NOM. Fifteen patients (7.8%) underwent SAE. Embolization was proximal in 10, distal in 1, and combined in 4 patients. No NOM failures occurred. Major complications (27%) included splenic bleeding, splenic infarction, splenic abscess, and contrast-induced renal insufficiency. Minor complications of fever, pleural effusions, and coil migration occurred in 53% of patients. No relationship between SAE location and the presence of complications was noted.

Conclusions: SAE is an effective and safe procedure. Both major and minor complications can arise after SAE.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Embolization, Therapeutic / adverse effects*
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Radiography
  • Retrospective Studies
  • Risk Assessment
  • Spleen / diagnostic imaging
  • Spleen / injuries*
  • Splenic Artery
  • Treatment Outcome
  • Wounds, Nonpenetrating / diagnostic imaging
  • Wounds, Nonpenetrating / therapy*