Trauma associated splenic artery aneurysms: an analysis of the National Trauma Data Bank

• Published in: The American journal of surgery 2016-04, Vol.211 (4), p.739-743
• Main Authors: Nembhard, Christine E., M.D, Hwabejire, John O., M.D., M.P.H, Obirieze, Augustine C., M.B.B.S., M.P.H, Oyetunji, Tolulope A., M.D., M.P.H, Cornwell, Edward E., M.D, Greene, Wendy R., M.D, Siram, Suryanarayana M., M.D
• Format: Article
• Language: English
• Subjects: Adult; Aneurysm - etiology; Aneurysm - mortality; Aneurysm - surgery; Aneurysms; Emergency medical care; Female; Hospital Mortality; Hospitalization; Humans; Injury Severity Score; Length of Stay - statistics & numerical data; Male; Mortality; Pseudoaneurysm; Registries; Retrospective Studies; Splenic Artery - injuries; Splenic artery aneurysm; Surgery; Trauma; Treatment; Treatment Outcome; United States - epidemiology; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - mortality; Wounds, Nonpenetrating - surgery
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2015.11.017

Abstract Background Trauma associated splenic artery aneurysm (SAA) is potentially life threatening and infrequently studied. We evaluated the subject using a large trauma database. Methods The National Trauma Data Bank (2002 to 2006) was queried. All patients aged greater than or equal to 18 years with a primary diagnosis of SAA (International Classification of Diseases: Ninth Revision code 442.83) were identified. Data on demographics, injury severity, pre-existing comorbidities, surgical interventions, complications, and mortality were analyzed. Results One hundred twenty-four patients were included with a mean age of 40 ± 13 years and 72% were male. Mean Injury Severity Score was 24 ± 12. All patients suffered blunt trauma, and 5% of the patients (n = 6) had systolic blood pressure less than 90 mm Hg on arrival. The most frequent interventions were surgical ligation of aneurysm (45%), bronchoscopy (35%), endovascular procedures (27%), splenectomy (27%), and thoracostomy tube (25%). About 1.7% developed pulmonary collapse. Mean length of stay was 13 days and mortality was 1.6%. Conclusions Trauma associated SAA has low mortality and most patients require surgical intervention. Pulmonary dysfunction and invasive pulmonary procedures are frequent despite low rate of chest injuries possibly due to anatomic proximity of lung and spleen.