International Journal of General Medicine (May 2023)
Splenic Artery Embolization in Conservative Management of Blunt Splenic Injury Graded by 2018 AAST-OIS: Results from a Hospital in Vietnam
Abstract
Van Thang Nguyen,1,2,* Hong Duc Pham,2,3,* Van Phan Nguyen Thanh,4 Thanh Dung Le5,6 1Radiology Department, Hai Duong Medical Technical University, Hai Duong, Vietnam; 2Radiology Department, Hanoi Medical University, Hanoi, Vietnam; 3Radiology Department, Saint Paul Hospital, Hanoi, Vietnam; 4Department of Biochemistry, Pham Ngoc Thach University of Medicine, Ho Chi Minh city, Vietnam; 5Radiology Department, Viet Duc University Hospital, Hanoi, Vietnam; 6Department of Radiology, VNU University of Medicine and Pharmacy, Hanoi, Vietnam*These authors contributed equally to this workCorrespondence: Van Phan Nguyen Thanh, Department of biochemistry, Pham Ngoc Thach University of Medicine, 2 Duong Quang Trung Street, Ho Chi Minh city, 700000, Vietnam, Tel +84919691770, Email [email protected]: This study was conducted to evaluate the results of conservative management of blunt splenic trauma according to the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) in 2018 by embolization.Methods: This observational study included 50 patients (42 men and 8 women) with splenic injury who underwent multidetector computed tomography (MDCT) and embolization.Results: According to the 2018 AAST-OIS, 27 cases had higher grades than they did according to the 1994 AAST-OIS. The grades of two cases of grade II increased to grade IV; those of 15 cases of grade III increased to grade IV; and four cases of grade IV increased to grade V. As a result, all patients underwent successful splenic embolization and were stable at discharge. No patients required re-embolization or conversion to splenectomy. The mean hospital stay was 11.8± 7 days (range, 6– 44 days), with no difference in length of hospital stay among grades of splenic injury (p > 0.05).Conclusion: Compared with the AAST-OIS 1994, the AAST-OIS 2018 classification is useful in making embolization decisions, regardless of the degree of blunt splenic injury with vascular lacerations visible on MDCT.Keywords: blunt splenic trauma, multidetector computed tomography, MDCT, splenic embolization
