Management of Splenic Rupture and Return-to-Play Decisions in a College Football Player

Terrell, Thomas R.; Lundquist, Bryan

doi:10.1097/00042752-200211000-00013

Cited by 14 publications

(15 citation statements)

References 8 publications

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“…Poulin described a partial splenectomy successfully performed laparoscopically following selective embolization of an extravasating pseudoaneurysm [15] and more recently Pucci reported a laparoscopic splenectomy for delayed hemorrhage following embolization [16]. Most reports are of prophylactic removal for low-grade injuries in very active individuals that are not bleeding [17][18][19]. We are not aware of any reports of laparoscopic removal of abscessed spleens following embolization.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic splenectomy for blunt trauma: a safe operation following embolization

Ransom¹,

Kavic

2008

Surg Endosc

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Section: Discussionmentioning

confidence: 99%

Laparoscopic splenectomy for blunt trauma: a safe operation following embolization

Ransom¹,

Kavic

2008

Surg Endosc

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“…In fact, there are case reports of high level athletes choosing splenectomy, rather than nonoperative healing, to return to full-contact sports. 18 …”

Section: Discussionmentioning

confidence: 99%

Splenic Lacerations and Return to Play

et al. 2011

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Background:Several sports medicine reviews have highlighted a 3- to 6-month time frame for return to play after splenic lacerations. These reviews are based on several well-defined grading scales for splenic injury based on computed tomography (CT). None of the articles suggest that serial CT scanning is necessary for follow-up; some even indicate that it has no role in the management of these injuries.Hypothesis:With proper follow-up and possibly the use of serial CT scanning or other imaging modalities, it may be possible for athletes to safely return to play sooner than what current guidelines recommend.Study Design:The authors present 2 cases of professional hockey players who both suffered grade III splenic lacerations while playing.Methods:Both players were treated conservatively and monitored with serial CT scanning until radiographic and clinical findings suggested complete healing.Results:Both players were able to return to full-contact professional hockey within 2 months after suffering grade III splenic lacerations. Neither athlete suffered any complications after his return.Conclusions:With CT scanning, 2 athletes were able to return to play earlier (2 months) than previously recommended (3-6 months) without compromising their safety.Clinical relevance:Additional cases must be examined before outlining more definitive recommendations regarding splenic lacerations in sports, but it is possible that elite athletes may return to play sooner than what the current literature recommends.

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“…There is a lack of consensus on recommendations for resuming full activity after blunt splenic and hepatic injuries. 13 , 15 , 17 , 21 , 37 , 51 Controversy stems from an inability to accurately predict delayed complications and the time needed for full recovery.…”

Section: Return-to-play Guidelinesmentioning

confidence: 99%

“… 5 , 55 The spleen and liver are the 2 most commonly injured organs in blunt abdominal trauma, with splenic injuries leading the way. 10 , 15 , 51 Injuries to the abdomen can occur in almost any sport but are more common in contact or collision sports. Injury to the spleen and the liver have occurred from tackling in football, 34 , 39 , 51 checking in hockey, 46 landing on a ball in rugby, 38 a blow to the abdomen from a boogie board 6 or lacrosse ball, 18 and even in downhill skiing and snowboarding.…”

mentioning

confidence: 99%

“… 10 , 15 , 51 Injuries to the abdomen can occur in almost any sport but are more common in contact or collision sports. Injury to the spleen and the liver have occurred from tackling in football, 34 , 39 , 51 checking in hockey, 46 landing on a ball in rugby, 38 a blow to the abdomen from a boogie board 6 or lacrosse ball, 18 and even in downhill skiing and snowboarding. 4 Delayed splenic rupture 3 weeks after being crosschecked during an amateur hockey game has occurred.…”

mentioning

confidence: 99%

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Return to Play After Liver and Spleen Trauma

Juyia

Kerr

2014

Sports Health

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Context:Sport-related spleen and liver injuries pose a challenge for the physician. Although rare, these injuries can have serious and even life-threatening outcomes if not accurately diagnosed and managed in a timely fashion. Currently, there are no evidence-based guidelines on duration and intensity of restricted activity and return to play after spleen and liver injury. In addition, there is controversy on follow-up imaging after injury.Evidence Acquisition:PubMed was searched using the terms splenic or spleen and trauma and hepatic or liver and trauma from 1980 to 2013. The citations from sentinel papers were also reviewed.Study Design:Clinical review.Level of Evidence:Level 3.Results:Ultrasound is ideal in the unstable athlete. Nonoperative management of blunt splenic and hepatic injuries is recommended for hemodynamically stable patients regardless of injury grade, patient age, or presence of associated injuries. Follow-up imaging is not routinely recommended unless clinically indicated. Athletes may engage in light activity for the first 3 months after injury and then gradual return to unrestricted activity as tolerated. High-level athletes may choose splenectomy or serial imaging for faster return to play.Conclusion:Intravenous contrast-enhanced computed tomography is the diagnostic imaging modality of choice in stable athletes with blunt abdominal trauma.Strength-of-Recommendation Taxonomy:C.

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Management of Splenic Rupture and Return-to-Play Decisions in a College Football Player

Cited by 14 publications

References 8 publications

Laparoscopic splenectomy for blunt trauma: a safe operation following embolization

Laparoscopic splenectomy for blunt trauma: a safe operation following embolization

Splenic Lacerations and Return to Play

Return to Play After Liver and Spleen Trauma

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