Background: To define the immunologic status of patients undergoing splenic embolization (SE) after traumatic injury. This information may lead to the development of immunization protocols based on scientific data.
Methods: Patients with traumatic splenic injury, treated at one level II Trauma Center were eligible for study. SE patients were compared with splenectomy (SP) patients and controls (C = blunt abdominal trauma patients with negative abdominal computed tomography scans). Clinical examination, medical survey, blood sampling, and nuclear medicine spleen scans were performed. IgM, IgG, C3 complement, complement factor B, helper T cells (CD3, CD4), suppressor T-cells (CD8), complete blood counts, and HIV status were tested. Radionuclide spleen scans were analyzed for total spleen volume, splenic defects, abnormal radionuclide uptake, and ectopic sites of tracer uptake.
Results: There were no significant differences in age, gender, or injury severity score among groups. Follow-up time was comparable (SP = 2.67 years; SE = 2.88 years). There were no significant differences in all studies measured except for higher CD8 levels in the SP group (730.1 vs. SE 452.1 vs. C 480.6; p = 0.002), although all values were within the normal range. CD3 levels showed a trend of being higher in the SP group (1709.3 vs. SE 1397.2 vs. C 1371.9), but were not statistically significant.
Conclusion: The data suggest that the immunologic profile of embolized patients is similar to controls. This supports the safe use of SE in managing the traumatically injured spleen. Larger studies examining the immune function after SE will be needed to make definitive vaccination recommendations.
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http://dx.doi.org/10.1097/TA.0b013e3181a5e7e2 | DOI Listing |
Radiol Case Rep
March 2025
University of Maryland School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Division of Vascular and Interventional Radiology, Baltimore, MD, USA.
Splenic steal syndrome (SSS) post liver transplant is a potential cause of graft dysfunction in the setting of peripheral hepatic arterial bed resistance and redirection of blood flow to a dominant splenic artery resulting in reduction of hepatic arterial inflow. We report utilization of balloon occlusion of the proximal splenic artery as an objective measure to confirm the diagnosis of SSS in a patient with orthotopic liver transplant followed by successful treatment with proximal splenic artery embolization using Gelfoam and Amplatzer vascular plug. Written informed consent for the publication of this case report was obtained from the patient.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Diagnostic and Interventional Radiology, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
Background: The spleen is commonly injured in trauma and this may be managed with a conservative approach, embolisation or splenectomy. There is uncertainty how splenic embolisation fits into the treatment paradigm and the delivery of IR services remains variable.
Aims And Objectives: The primary objectives are to determine if service design significantly affects splenic embolisation (SE) rates in AAST grade 2-5 acute traumatic splenic injuries (ATSI) across the Major Trauma Centres (MTCs) in England and to determine if variation in treatment affects SE outcomes in ATSI.
Nucl Med Commun
February 2025
Department of Radiology, Netherlands Cancer Institute- Antoni van Leeuwenhoekziekenhuis, Amsterdam, The Netherlands.
Background: Small-molecule biomacromolecules target tumor-specific antigens. They are employed as theranostic agents for imaging and treatment. Intravenous small-molecule radioligands exhibit rapid tumor uptake and excretion.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Emergency Medicine Department, Lebanese American University Medical Center, Beirut, Lebanon. Electronic address:
Introduction: Accessory spleens are a common anatomical variant, consisting of ectopic splenic tissue present in different locations in the peritoneal cavity. Typically asymptomatic, the presence of these tissue grows to be of clinical importance when complicated by infarction, rupture, or torsion.
Presentation Of Case: We report the case of a 36-year-old female that presented to the Emergency Department for diffuse abdominal pain and was found to have a partially ruptured splenule secondary to a venous infarct on abdominal computed tomography scan.
Cureus
December 2024
Department of Gastroenterology, Scripps Mercy Hospital, San Diego, USA.
Hemosuccus pancreaticus (HP) is a rare, life-threatening cause of upper gastrointestinal bleeding, often linked to chronic pancreatitis and pseudoaneurysm rupture into the pancreatic duct. However, its occurrence in acute necrotizing pancreatitis with decompensated cirrhosis is exceedingly rare and poses significant diagnostic and treatment challenges. We report a case of a 34-year-old male with decompensated alcoholic cirrhosis who developed hemorrhagic shock from HP following acute necrotizing pancreatitis.
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