Proximal splenic artery embolization for blunt splenic injury: clinical, immunologic, and ultrasound-Doppler follow-up.

Détails

ID Serval
serval:BIB_0F49740891A4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Proximal splenic artery embolization for blunt splenic injury: clinical, immunologic, and ultrasound-Doppler follow-up.
Périodique
Journal of Trauma
Auteur(s)
Bessoud B., Duchosal M.A., Siegrist C.A., Schlegel S., Doenz F., Calmes J.M., Qanadli S.D., Schnyder P., Denys A.
ISSN
1529-8809 (Electronic)
ISSN-L
0022-5282
Statut éditorial
Publié
Date de publication
2007
Volume
62
Numéro
6
Pages
1481-1486
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
BACKGROUND: To evaluate the clinical, US (ultrasound)-Doppler and hematologic findings after proximal splenic artery embolization (PSAE) for blunt injury.
METHODS: From August 1998 to February 2003, 37 patients (28 men and 9 women; 20-89 years old, mean 40 years) underwent PSAE for blunt injuries. One patient required secondary splenectomy after PSAE. Early complications were investigated during the hospital stay. Delayed follow-up included review of the outpatient records, telephone interview, consultation, US-Doppler splenic study, Howell-Jolly body search, and serum antibody titer determinations (pneumococcus and Haemophilus influenzae B).
RESULTS: No early postprocedural complications were depicted. Ten patients were lost on follow-up. Two patients had a telephone interview that revealed no complication. Twenty-four patients were examined 6 to 63 (mean 26) months after the embolization. No late complication was reported. Splenic measurements were in the normal range: length (53-110 mm; mean, 73), width (49-110 mm; 76), thickness (26-56 mm; 38), volume (61-508 mL; 226), standard ellipsoid formula volume (32-265 mL; 118), corrected volume (29-238 mL; 106), and splenic volumetric index (2.3-18.8; 8.4). The spleen was homogeneous in 23 patients (96%). Intrasplenic vascularization was present and splenic vein was patent in all patients. Howell-Jolly bodies were found in two patients. All patients (24 of 24) evaluated for exposure-driven immunity against Haemophilus Influenza b had sufficient immunity. Seventeen of the 18 patients (94%) evaluated for exposure-driven immunity against pneumococcus had sufficient immunity. Five of the six patients (83%) evaluated for pneumococcus vaccine response had a sufficient response.
CONCLUSIONS: Proximal splenic artery embolization in blunt splenic injuries is a well-tolerated technique without major long-term impact on the splenic anatomy and immune function.
Mots-clé
Abdominal Injuries/immunology, Abdominal Injuries/ultrasonography, Adult, Aged, Aged, 80 and over, Angiography, Embolization, Therapeutic, Female, Humans, Male, Middle Aged, Spleen/blood supply, Spleen/injuries, Splenic Artery/radiography, Tomography, X-Ray Computed, Ultrasonography, Doppler, Wounds, Nonpenetrating
Pubmed
Web of science
Création de la notice
11/04/2008 12:51
Dernière modification de la notice
20/08/2019 13:36
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