• Journal of Trauma and Injury
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• 제19권2호
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• pp.196-200
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• 2006

We report a case of celiac artery dissection after abdominal blunt trauma. A 29-year-old man visited the emergency room for acute left periumbilical pain after abdominal blunt trauma from his child. Computed tomography showed a wedge-shaped splenic infarction with splenic artery thrombus. He was hospitalized for careful observation, and after two days, follow-up computed tomographic angiography showed a progressed celiac artery dissection that involved common hepatic artery and an increased extent of splenic infarction. He underwent conventional angiography, and a self-expandable stent was placed between the celiac axis and the common hepatic artery. After two days, follow-up computed tomographic angiography showed good hepatic arterial blood flow via the stent and no progression of splenic infarction. After ten days, he was discharged without complications.

• Parasites, Hosts and Diseases
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• 제53권2호
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• pp.215-218
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• 2015

An enlarged spleen is considered one of the most common signs of malaria, and splenic rupture rarely occurs as an important life-threatening complication. Splenectomy has been recommended as the treatment of choice for hemodynamically unstable patients. However, a very limited number of splenic rupture patients have been treated with transcatheter coil embolization. Here we report a 38-year-old Korean vivax malaria patient with ruptured spleen who was treated successfully by embolization of the splenic artery. The present study showed that angiographic embolization of the splenic artery may be an appropriate option to avoid perioperative harmful effects of splenectomy in malaria patients.

• Journal of Trauma and Injury
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• 제34권2호
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• pp.141-145
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• 2021

Splenic injury is a common result of blunt trauma, and bleeding occurs mainly inside the splenic capsule and may leak into the peritoneal space. Herein, we report a case where active bleeding occurred in the splenic artery and only leaked into the extraperitoneal space. This is the first case of this phenomenon in a trauma patient in the English-language literature. Bleeding passed through the peritoneum, leaked into the anterior pararenal space, and continued along the extraperitoneal space to the prevesical space of the pelvis. Therefore, on the initial computed tomography (CT) scan, the bleeding appeared to be in the left paracolic gutter, so we suspected mesenteric bleeding. However, after the CT series was fully reconstructed, we accurately read the scans and confirmed splenic injury with active bleeding. If there had been a suspicion of bowel or mesenteric injury, surgery would have been required, but fortunately surgery could be avoided in this case. The patient was successfully treated with angioembolization.

• 한국간담췌외과학회지
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• 제26권4호
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• pp.386-394
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• 2022

Splenic artery steal syndrome (SASS) is a cause of graft hypoperfusion leading to the development of biliary tract complications, graft failure, and in some cases to retransplantation. Its management is still controversial since there is no universal consensus about its prophylaxis and consequently treatment. We present a case of SASS that occurred 48 hours after orthotopic liver transplantation (OLTx) in a 56-year-old male patient with alcoholic cirrhosis and severe portal hypertension, and who was successfully treated by splenic artery embolization. A literature search was performed using the PubMed database, and a total of 22 studies including 4,789 patients who underwent OLTx were relevant to this review. A prophylactic treatment was performed in 260 cases (6.2%) through splenic artery ligation in 98 patients (37.7%) and splenic artery banding in 102 (39.2%). In the patients who did not receive prophylaxis, SASS occurred after OLTx in 266 (5.5%) and was mainly treated by splenic artery embolization (78.9%). Splenic artery ligation and splenectomies were performed, respectively, in 6 and 20 patients (2.3% and 7.5%). The higher rate of complications registered was represented by biliary tract complications (9.7% in patients who received prophylaxis and 11.6% in patients who developed SASS), portal vein thrombosis (respectively, 7.3% and 6.9%), splenectomy (4.8% and 20.9%), and death from sepsis (4.8% and 30.2%). Whenever possible, prevention is the best way to approach SASS, considering all the potential damage arising from an arterial graft hypoperfusion. Where clinical conditions do not permit prophylaxis, an accurate risk assessment and postoperative monitoring are mandatory.

• Advances in pediatric surgery
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• 제6권2호
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• pp.143-148
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• 2000

Pseudoaneurysm of the splenic artery may arise from a vascular erosion by a surrounding inflammatory processes in acute and chronic pancreatitis. Rupture of the pseudoaneurysm may threaten the patient's life. Conservative management for massive hemorrhage may cause 100 percent mortality and even with prompt therapy there is a high mortality. Preoperative detection of bleeding source is desirable because of the difficult identification of the bleeding site at laparotomy. Angiographic identification and embolization of the hemorrhagic vessels in selected cases may obviate the risk of urgent surgery. The authors have recently managed a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography confirmed the diagnosis. We managed this child successfully with the urgent transcatheter arterial embolization followed by elective surgery.

• 대한수의학회지
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• 제8권2호
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• pp.80-83
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• 1968

This study was conducted to ramify of the Rami lienales at the hilus of the spleen in Korean cattle. The materials used were fifty spleens, 25 fresh samples, and 25 Cast specimens. The results obtained are summarized as follows. 1. The splenic arteries were divided into 2 Rami lienales (32 cases, 64%) and 3 Rami lienales(18 cases, 36%). and their branches were nominated as Aa, terminales superior et inferior and A. polares superior. 2. To ramify the A. terminalis superior and A. terminalis inferior, only one case diverged in the splenic parenchyma and 49 cases diverged in the outside of the spleen. 3. Immediately after dividing from the splenic artery to the Aa. terminales superior and inferior, the calibres of the A. terminalis inferior were larger than the A. terminalis superior (sup. 5.5 mm., inf. 8. 5mm.). 4. It was also observed, in all samples used. that Rami lienalis of the splenic artery were not anastomosis in the out side of the spleen.

• Parasites, Hosts and Diseases
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• 제57권4호
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• pp.405-409
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• 2019

In malaria, splenic rupture is a serious complication potentially leading to death. Subcapsular hemorrhage of spleen is thought to be an impending sign of splenic rupture; however, the characteristics of subcapsular hemorrhage are not well known. We report 3 cases of subcapsular hemorrhage of the spleen in vivax malaria, with varying degrees of severity. Case 1 showed subcapsular hemorrhage without splenic rupture, was treated by antimalarial drug without any procedure. The healing process of the patient's spleen was monitored through 6 computed tomography follow-up examinations, over 118 days. Case 2 presented subcapsular hemorrhage with splenic rupture, treated only with an antimalarial drug. Case 3 showed subcapsular hemorrhage with splenic rupture and hypotension, treated using splenic artery embolization. They all recovered from subcapsular hemorrhage without any other complications. These 3 cases reveal the process of subcapsular hemorrhage leading to rupture and a potentially fatal outcome. The treatment plan of subcapsular hemorrhage should be determined carefully considering the vital signs, changes in hemoglobin, and bleeding tendency.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.431-434
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• 2023

Severe blunt injuries to isolated solid abdominal viscera have been previously managed nonoperatively; however, management algorithms for simultaneous visceral injuries are less well defined. We report a polytrauma case of a 33-year-old man involved in a motorbike collision who presented with left-sided chest and abdominal pain. Initial imaging demonstrated multiple solid organ injuries with American Association for the Surgery of Trauma (AAST) grade V splenic injury and complete devascularization of the left kidney. The patient underwent urgent angioembolic coiling of the distal splenic artery with successful nonoperative management of simultaneous grade V solid organ injuries.

• Journal of Chest Surgery
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• 제22권2호
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• pp.325-329
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• 1989

A rare case of aneurysm of the celiac artery due to arteriosclerosis was presented. The patient was 56-year-old female and had suffered from hypertension for 4 years, and recently, from dyspepsia prior to admission for 2 months. The operation was operated upon by interposition of an autogenous tubular saphenous vein graft between the proximal celiac artery and the common opening of the hepatic and the splenic arteries in the opened aneurysmal sac with inclusion technique. The postoperative course was uneventful.

• Clinical and Experimental Pediatrics
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• 제52권9호
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• pp.1029-1034
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• 2009

가와사끼병은 주로 소아기에 발생하는 급성 전신 혈관염으로, 원인은 아직 명확히 알려져 있지 않다. EBV는 전염성 단핵구증의 원인으로 잘 알려져 있으며, 또한 가와사키병의 원인으로도 보고된 바 있다. 가와사끼병으로 인한 합병증은 관상동맥류를 포함한 심혈관계 합병증이 주를 이루지만, 다양한 종류의 합병증들이 보고 되고 있다. 저자들은 EBV 감염과 연관된 전염성 단핵구증, 거대 관상동맥류, 심낭삼출, 비경색증이 동반된 난치성 가와사끼병 환자 1예를 경험하였기에 보고하는 바이다. 환자는 3번의 면역글로불린 치료에도 반응이 없었지만, pulse methylprednisolone 치료 후에 임상 증상은 급격히 호전되었고, 거대 관상동맥류만 지금까지 지속되고 있다.