Two cases of delayed splenic rupture treated successfully by transcatheter arterial embolization

Abstract

We report two cases of delayed splenic rupture that were treated successfully by transcatheter arterial embolization (TAE), with a review of the literature. Case 1: A 35-year-old woman presented to our hospital with trauma to the left side of the abdomen. Because CT on admission revealed splenic injury (Type IIIb according to the 2008 Classification of Splenic Injury of the Japanese Association for the Surgery of Trauma), she was treated with TAE. Six days after admission, she complained of acute abdominal pain. Based on abdominal CT findings of an enlarged spleen with fluid collection in the peritoneal cavity, delayed splenic rupture was subsequently diagnosed. Splenic arteriography demonstrated a pseudoaneurysm, and the middle pole branch of the splenic artery was occluded by micro coils. The patient recovered uneventfully and was discharged after 21 days. Case 2: A 34-year-old man injured his left lateral abdomen in an accident. He visited his primary care physician, 20 days after the event, because of acute abdominal pain. He was referred to our hospital for hypotension. CT on admission showed splenic injury (Type III b), and therefore, he underwent selective TAE. Delayed splenic rupture was diagnosed due to the length of time between his injury and the occurrence of symptoms. The patient recovered and was discharged after 5 days.