Abstract No. 253 EE: Blunt Splenic Injury: Review of Current Imaging Techniques, Grading Systems, and Endovascular Treatments

Abstract

The purpose of this educational exhibit is to review the state-of-art imaging techniques, grading systems, and endovascular treatments used in the nonoperative management of blunt splenic injury. Nonoperative management of blunt splenic trauma has become the treatment of choice for hemodynamically stable patients. Therefore, the radiologist/interventional radiologist is playing a greater role in diagnosis, management, and treatment. This educational exhibit will utilize experience from a Level 1 trauma center with 400 hemodynamically stable patients evaluated for blunt splenic injury over a 30-month period. We will review the most up-to-date imaging techniques and their sensitivity, specificity, limitations, and role in the diagnosis and characterization of blunt splenic injury, including multidetector CT, conventional angiography, and ultrasound. In addition, this exhibit will pictorially review and compare common grading systems utilized in the management of blunt splenic trauma, including the American Association for the Surgery of Trauma splenic injury scale and a CT-based splenic injury grading system proposed by members of our imaging team. Imaging findings predicting the need for endovascular treatments will be highlighted. Endovascular treatment algorithms and techniques used in the management of blunt splenic injury will also be reviewed with discussion of postcoil embolization surveillance, management, and complications. An up-to-date understanding of the imaging techniques, grading systems, and endovascular treatments used in the nonoperative management of blunt splenic injury is essential for the practicing radiologist/interventional radiologist.