Splenic trauma

Background

  • Most commonly injured visceral organ in blunt trauma

Clinical Features

  • LUQ pain
  • Signs of shock
  • Hypotension
  • Left lower rib pain
  • Kehr's sign

Differential Diagnosis

Abdominal Trauma

Diagnosis

  • FAST to search for free fluid
  • CT scan
  • Exploratory laparotomy in unstable pts

Management

  • Nonoperative management
    • 24-72 hours strict bed rest
    • Repeat CT 7 days after injury
    • Nonoperative management of splenic injuries has failure rate of 10-15%
    • Some advocate nonoperative management only if <55yr and CT injury grade less than IV

Disposition

See Also

References

  • Rosens