Traumatic Hemorrhage of the Spleen Diagnosed by CO2-DSA.
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We report a case of splenic injury in which intra-arterial digital subtraction angiography with carbon dioxide (CO2-DSA) was very valuable in the diagnosis of traumatic hemorrhage. A 24-year-old man was admitted with blunt trauma to the left flank following a traffic accident. Ultrasonography and computed tomography (CT) revealed rupture of the lower portion of the spleen. Conventional angiography and DSA with iodine contrast material revealed hypovascularity of the lower portion of the spleen suggesting fragmentation. Marked extravasation from the splenic arterial branch was demonstrated only by CO2-DSA. Although the patient was hemodynamically stable, the intraperitoneal fluid was increased on the ultrasonogram and the hematocrit gradually decreased to 25.6%. Ultimately partial splenectomy was performed 53 hours after the injury. The lower portion of the spleen had been transected and the volume of intraperitoneal hemorrhage was 2, 000ml. Thus, CO2-DSA has proved to be superior to other tests in the diagnosis of traumatic hemorrhage after blunt abdominal trauma. This case suggests that extravasation of CO2 on DSA may require transarterial embolization or surgery.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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