Blunt splenic trauma in adults: can CT findings be used to determine the need for surgery?

Becker, Christoph; Spring, Paul M.; Glättli, A; Schweizer, W

doi:10.2214/ajr.162.2.8310923

Cited by 106 publications

(48 citation statements)

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“…The review article published by Aubrey-Bassler and Sowers [4] mentioned four case reports of spontaneous rupture of spleen following vomiting [1,[17][18][19][20][21][22][23][24][25][26][27][28][29], and one case report following seizure [20]. There have also been case reports of spontaneous rupture of spleen following colonoscopy, endoscopic retrograde cholangiopancreatography, hepatic and pulmonary surgery and even emission computed tomography, laparoscopy and hysterectomy [4].…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Splenic Rupture Following Bouts of Coughing: A Rare Case Report and Literature Review

Biswas

Richards

2016

J Curr Surg

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Splenic rupture due to trauma is relatively common. However, spontaneous non-traumatic ruptures do occur. Causes include infection, neoplasia and infiltrative process. We present an unique case of a 59-year-old patient who presented with dyspnea and left upper abdominal discomfort following bouts of coughing, and was provisionally diagnosed as pulmonary embolism. CT scan revealed splenic rupture. Only a few case reports are published documenting spontaneous splenic rupture following coughing. The therapy of choice can vary between patients depending on the grade of splenic rupture, hemodynamic instability, availability of endovascular treatment and physician preference. Treatment should be focused on preserving splenic tissue if feasible. Non-traumatic rupture of the spleen must be considered in patients presenting with left-sided upper abdominal pain even without evident history of trauma, since early recognition and treatment can prevent serious morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

“…Lower-grade injuries are typically managed conservatively while higher-grade injuries often require surgery. Nevertheless, much evidence supports the idea that the clinical circumstances should be the most important aspect in managing the patient [28].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Splenic Rupture Following Bouts of Coughing: A Rare Case Report and Literature Review

Biswas

Richards

2016

J Curr Surg

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“…In den epidemologischen Studien zum Polytrauma zeigt sich mit 65% -80% eine deutliche Dominanz der männlichen Unfallopfer (79,86,101 Eine mögliche Schwierigkeit in der Beurteilung der Milz sehen einige Autoren in der inhomogenen Kontrastmittelaufnahme der Milz, wenn diese in einer arteriell betonten Kontrastmittelphase dargestellt wird (7,59,91). Die CT-Untersuchung des Abdomens kann somit eine wichtige Grundlage zur präziseren Planung des therapeutischen Vorgehens, insbesondere auch der differenzierteren Indikationsstellung zur Laparotomie bilden (65).…”

Section: Epidemiologieunclassified

“…Die diagnostische Überlegenheit der Computertomographie des Abdomens in der genaueren Erfassung des abdominellen Gesamtverletzungsmusters gegenüber der Sonographie ist von zahlreichen Autoren hervorgehoben worden (5,6,24,91 (4,5,6,7,44,59,60,91).…”

Section: Abdomenunclassified

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Primäre bildgebende Diagnostik von polytraumatisierten Patienten mittels Spiralcomputertomographie

Siegmann

2001

Trauma und Berufskrankheit

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Delayed Complications of Nonoperative Management of Blunt Adult Splenic Trauma

et al. 1998

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Setting: University teaching hospital, level I trauma center. Patients: Two hundred eighty patients were admitted to the adult trauma service with blunt splenic injury during a 4-year period. Men constituted 66% of the population. The mean (±SEM) age was 32.2±1.0 years and the mean (±SEM) Injury Severity Score was 22.8±0.9. Fiftynine patients (21%) died of multiple injuries within 48 hours and were eliminated from the study. One hundred thirty-four patients (48%) were treated operatively within the first 48 hours after injury and 87 patients (31%) were managed nonoperatively. Main Outcome Measures: We reviewed the number of units of blood transfused, intensive care unit length of stay, overall length of stay, outcome, and complications occurring more than 48 hours after injury directly attributable to the splenic injury. Results: Patients managed nonoperatively had a significantly lower Injury Severity Score (P<.05) than patients treated operatively. Length of stay was significantly decreased in both the number of intensive care unit days as well as total length of stay (P<.05). The number of units of blood transfused was also significantly decreased in patients managed nonoperatively (P<.05). Seven patients (8%) managed nonoperatively developed delayed complications requiring intervention. Five patients had overt bleeding that occurred at 4 days (3 patients), 6 days (1 patient), and 8 days (1 patient) after injury. Three patients underwent splenectomy, 1 had a splenic artery pseudoaneurysm embolization, and 1 had 2 areas of bleeding embolization. Two patients developed splenic abscesses at approximately 1 month after injury; both were treated by splenectomy. Conclusion: Significant numbers of delayed splenic complications do occur with nonoperative management of splenic injuries and are potentially lifethreatening.

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Blunt splenic trauma in adults: can CT findings be used to determine the need for surgery?

Abstract: OBJECTIVE.The role of CT grading of blunt splenic injuries is still controversial.We studied the CT scans of adult patients with proved blunt splenic injuries to deter-

Cited by 106 publications

References 0 publications

Spontaneous Splenic Rupture Following Bouts of Coughing: A Rare Case Report and Literature Review

Spontaneous Splenic Rupture Following Bouts of Coughing: A Rare Case Report and Literature Review

Primäre bildgebende Diagnostik von polytraumatisierten Patienten mittels Spiralcomputertomographie

Delayed Complications of Nonoperative Management of Blunt Adult Splenic Trauma

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