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Adult Blunt Splenic Trauma algorithm

Adult Blunt Splenic Trauma Notes:
Introduction
Historic Perspective
Table 1
Note A Table 2 Note B Note C Note D Note E Note F Table 3 Note G Note H Note I Note J Note K References

  

 
Western Trauma Association
Management of Adult Blunt Splenic Trauma

 

Annotation for Point H

 
Arteriograghy requires transport to the interventional radiologist suite, where the patient should be monitored to the same standards as an intensive care unit. Therapeutic embolization is done if an aneurysm, arteriovenous fistula, or extravasation is found on the screening angiogram. There is some controversy over the optimal method of AE (i.e., main splenic artery embolization vs. distal selective artery embolization vs. combination). Main splenic artery embolization reduces bleeding by reducing perfusion pressure, but this may not prevent late pseudoanuerysm rupture and will likely not treat an arteriovenous fistula.42 On the other hand, distal selective embolization can effectively stop blood flow in polar arteries but can result in tissue infarction with local abscess formation. Local expert consensus should standardize these practices and prospectively characterize patient outcomes to define the best technique.

 

  
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