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Spleen

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Essential Interventional Radiology Review

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Abstract

The spleen is the most commonly injured organ in the setting of trauma, and overlooked splenic injury is the most common cause of preventable deaths in trauma patients. Although grades III-V splenic injuries have traditionally been treated with laparotomy and splenectomy, advances in angiography and embolization techniques have now made splenic artery embolization, considered a non-operative management method, the standard option for hemodynamically stable patients with CTA evidence for arterial extravasation. The main contraindications to splenic embolization include hemodynamic instability, pre-existing splenic disease, and multi-system trauma. Embolization options include proximal versus distal embolization, with indications, benefits, and risks for each approach. Unlike in splenectomy, splenic tissue is typically not lost after embolization due to the spleen’s rich collateral supply from adjacent vasculature. While patients require prophylactic vaccination against encapsulated bacteria after surgical splenectomy, such vaccinations are not mandatory after splenic embolization.

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Author information

Authors and Affiliations

  1. Division of Interventional Radiology, Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, USA

    Justin J. Guan

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  1. Justin J. Guan
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Editor information

Editors and Affiliations

  1. The Hospital for Sick Children, Toronto, Ontario, ON, Canada

    Rajat Chand

  2. Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Adam E. M. Eltorai

  3. Brown University, East Providence, RI, USA

    Terrance Healey

  4. Brown University, Providence, RI, USA

    Sun Ahn

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Guan, J.J. (2022). Spleen. In: Chand, R., Eltorai, A.E.M., Healey, T., Ahn, S. (eds) Essential Interventional Radiology Review. Springer, Cham. https://doi.org/10.1007/978-3-030-84172-0_47

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  • DOI: https://doi.org/10.1007/978-3-030-84172-0_47

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84171-3

  • Online ISBN: 978-3-030-84172-0

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