Successful nonoperative management of AAST grade IV splenic injury with splenic vein thrombosis without angioembolization: a case report
Abstract
High-grade splenic trauma remains challenging, particularly when associated with vascular complications. We report a man in his 20s who sustained blunt abdominal trauma and was diagnosed on contrast-enhanced computed tomography with an American Association for the Surgery of Trauma grade IV splenic injury, moderate haemoperitoneum, and splenic vein thrombosis without active arterial contrast extravasation. Although initially hypotensive, he stabilized after resuscitation with three units of packed red blood cells and three units of fresh frozen plasma. He was successfully managed nonoperatively with close clinical monitoring, serial haemoglobin assessment, and interval imaging. Follow-up imaging demonstrated reduction of haemoperitoneum and partial recanalization of the splenic vein, with complete radiological resolution at 10 months. This case demonstrates that carefully selected patients with high-grade splenic injury and traumatic splenic vein thrombosis may be managed successfully without angioembolization when haemodynamic stability is achieved and maintained.
Related
- Successful Nonoperative Management of Small Bowel Obstruction due to Distal Gastric Band Migration: A Rare Late Complication of LAGB
- Successful Medical Management of Obstructive Mechanical Mitral Valve Thrombosis Using Low-Dose, Ultraslow Infusion Thrombolytic Therapy: A Case Report.
- Near-total splenic infarction with pseudocystic transformation due to combined splenic artery and splenic vein thrombosis: CT-based diagnosis
- Nonoperative Management Is Associated With an Increased Risk of Adverse Mental Health Conditions in Elderly Patients With Distal Radius Fractures: A Retrospective Cohort Analysis.
- Nonoperative Management of an Acute Complete Achilles Tendon Rupture With Mesenchymal Stem Cells and Extracellular Vesicles: A Case Report.
BibTeX
@article{ramanujam2026successful,
title = {{Successful nonoperative management of AAST grade IV splenic injury with splenic vein thrombosis without angioembolization: a case report}},
author = {Rahul Ramanujam and Padmanabhan Ragumani and Manibalan Sekar},
journal = {Journal of Surgical Case Reports},
year = {2026},
month = oct,
doi = {10.1093/jscr/rjag948},
url = {https://doi.org/10.1093/jscr/rjag948},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Successful nonoperative management of AAST grade IV splenic injury with splenic vein thrombosis without angioembolization: a case report
AU - Rahul Ramanujam
AU - Padmanabhan Ragumani
AU - Manibalan Sekar
PY - 2026
DA - 2026/10/22
JO - Journal of Surgical Case Reports
DO - 10.1093/jscr/rjag948
UR - https://doi.org/10.1093/jscr/rjag948
AB - High-grade splenic trauma remains challenging, particularly when associated with vascular complications. We report a man in his 20s who sustained blunt abdominal trauma and was diagnosed on contrast-enhanced computed tomography with an American Association for the Surgery of Trauma grade IV splenic injury, moderate haemoperitoneum, and splenic vein thrombosis without active arterial contrast extravasation. Although initially hypotensive, he stabilized after resuscitation with three units of packed red blood cells and three units of fresh frozen plasma. He was successfully managed nonoperatively with close clinical monitoring, serial haemoglobin assessment, and interval imaging. Follow-up imaging demonstrated reduction of haemoperitoneum and partial recanalization of the splenic vein, with complete radiological resolution at 10 months. This case demonstrates that carefully selected patients with high-grade splenic injury and traumatic splenic vein thrombosis may be managed successfully without angioembolization when haemodynamic stability is achieved and maintained.
SN - 2042-8812
ER -