Conclusions With increases in technology and high resolution CT i

Conclusions With increases in technology and high resolution CT imaging, it is likely that more contrast blushes will be detected. Assuming that a hemodynamically stable patient requires angiography for investigation of a contrast blush is not based on scientific evidence. Based Selonsertib upon

our experience, albeit limited in numbers and retrospective in nature, we do not feel evidence of contrast extravasation on initial CT imaging alone is a definitive indication for intervention. A period of close observation, serial examination, repeat laboratory evaluation, repeat FAST for those with an initial negative FAST, and selective repeat CT imaging, click here should be considered. A clinically based approach, similar to that used in all patients to determine operative versus NOM of blunt splenic injuries, rather than immediate angiography could avoid costly, invasive interventions and their associated sequelae. Future prospective trials would help delineate patients with splenic blushes who can

be managed non-operatively, and could help develop treatment algorithms. References 1. Schurr MJ, Fabian TC, Gavant M, et al.: Management of blunt splenic trauma: GDC-0941 cell line computed tomographic contrast blush predicts failure of nonoperative management. J Trauma 1988, 28:828–831.CrossRef 2. Federle MP, Courcoulas AP, Peitzman AB, et al.: Blunt splenic injury in adults: clinical and CT criteria for management, with emphasis on active extravasation. Radiology 1998, 206:137–142.PubMed 3. Branched chain aminotransferase Bee TK,

Croce MA, Miller PR, Pritchard FE, Fabian TC: Failures of splenic nonoperative management: is the glass half empty or half full? J Trauma 2001,50(2):230–236.PubMedCrossRef 4. Haan JM, Bochicchio GV, Kramer N, Scalea TM: Nonoperative management of blunt splenic injury: a 5-year experience. J Trauma 2005, 58:492–498.PubMedCrossRef 5. Wei B, Hemmila MR, Arbabi S, Taheri PA, Wahl WL: Angioembolization reduces operative intervention for blunt splenic injury. J Trauma 2008, 64:1472–1477.PubMedCrossRef 6. Sclafani SJ, Shaftan GW, Scalea TM, et al.: Nonoperative salvage of computed tomography-diagnosed splenic injuries: utilization of angiography for triage and embolization for hemostasis. J Trauma 1995, 39:818–827.PubMedCrossRef 7. Davis KA, Fabian TC, Croce MA, et al.: Improved success in nonoperative management of blunt splenic injuries: embolization of splenic artery pseudoaneurysms. J Trauma 1998, 44:1008–1015.PubMedCrossRef 8. Haan JM, Biffl W, Knudson MM, et al.: Splenic embolization revisited: a multicenter review. J Trauma 2004, 56:542–547.PubMedCrossRef 9. Dent D, Alsabrook G, Erickson BA, et al.

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