“Beyond saving lives”: Current perspectives of interventional radiology in trauma

Figure 7 Grade IV splenic injury with active contrast extravasation in a 29-year-old male with blunt trauma abdomen, hemodynamically stable and FAST positive. Arterial phase image (A) showing blobs of contrast (arrow) marginating the deep splenic laceration. In portovenous phase (B), lacerations are better appreciated, few of which are involving splenic hilum. Also, blobs of contrast in the arterial images has slight increased in size (arrow), nonetheless, remain localised s/o focal active contrast extravasation. DSA was done (C and D), selective splenic artery angiogram showed multiple areas of active contrast extravasation from trabecular arteries of lower pole (arrow) with disruption of parenchymal continuity due to laceration (asterisk). Proximal embolization of splenic artery was done with coil followed by gelfoam instillation (E). Note coils (thin arrow) are deployed distal to the origin of dorsal pancreatic artery (thick arrow). Post embolization angiographic run (F) showed proximal contrast stasis with no opacification distal to embolization site. DSA: Digital subtraction angiography; FAST: Focused assessment with sonography in trauma.