Splenic Pseudoaneurysm after Blunt Splenic Injury

DOI 1 Citations 8 References
  • Oshima Kiyohiro
    Department of Emergency Medicine, Gunma University Graduate School of Medicine Emergency and General Medical Center, Gunma University Hospital
  • Hagiwara Shu-ichi
    Department of Emergency Medicine, Gunma University Graduate School of Medicine Emergency and General Medical Center, Gunma University Hospital
  • Murata Masato
    Department of Emergency Medicine, Gunma University Graduate School of Medicine Emergency and General Medical Center, Gunma University Hospital
  • Aoki Makoto
    Department of Emergency Medicine, Gunma University Graduate School of Medicine Emergency and General Medical Center, Gunma University Hospital
  • Kaneko Minoru
    Department of Emergency Medicine, Gunma University Graduate School of Medicine Emergency and General Medical Center, Gunma University Hospital
  • Furukawa Kazumi
    Department of Emergency Medicine, Gunma University Graduate School of Medicine Emergency and General Medical Center, Gunma University Hospital
  • Nakamura Takuro
    Department of Emergency Medicine, Gunma University Graduate School of Medicine Emergency and General Medical Center, Gunma University Hospital
  • Ohyama Yoshio
    Emergency and General Medical Center, Gunma University Hospital
  • Tamura Jun-ichi
    Emergency and General Medical Center, Gunma University Hospital

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Other Title
  • 鈍的脾損傷の経過中に発症した脾仮性動脈瘤の1例

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A case of splenic pseudoaneurysm after blunt splenic injury in a 63-year-old female is reported. She was transferred to our hospital due to multiple traumatic injuries sustained in a traffic accident. Enhanced computed tomography (CT) showed blunt splenic injury with intra-abdominal hemorrhage. Urgent angiography showed no extravasation from the splenic artery, and non-operative management was chosen, because the hemodynamics was stable. On the 9th hospital day, the patient felt sick after defecation. At that time, her systolic blood pressure and heart rates were <70/mmHg and <50/min, respectively, however, her condition immediately improved after fluid loading and administration of atropine. Ultrasonography performed at the same time showed no increase in the size of the hematoma around the spleen, however, a splenic pseudoaneurysm was suspected. Enhanced CT performed on the 11th hospital day revealed a splenic pseudoaneurysm with a diameter of 8mm, therefore, urgent catheter embolization was performed. Recently, non-operative management (NOM) has been the standard of care for hemodynamically stable blunt splenic injuries. A feared complication of NOM is delayed splenic rupture, and splenic pseudoaneurysm has attracted attention as a cause of delayed splenic rupture. Suitable and timely treatment of splenic pseudoaneurysm is necessary, because its rupture is life-threatening.

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