Splenic injury: sonographic investigation.
We report on sonographic findings in 30 patients with traumatic (n = 13) or non-traumatic (n = 17) splenic injury. An ultrasound (US)-based injury-severity-score consisting of three grades was devised and retrospectively applied in all patients. Initial sonographic abnormalities included: Intraperitoneal fluid (n = 10), perisplenic fluid (subcapsular hematoma) (n = 13), intrasplenic fluid (n = 10), splenic lacerations (n = 7) and intrasplenic flow phenomena diagnosed via Doppler-Ultra-sound (n = 3). The final diagnoses were splenic injury due to acute blunt traumatic episode (n = 9), chronic traumatic episode (n = 2), infectious mononucleosis (n = 2), splenic infarction (n = 14), and various causes (n = 3). On the basis of both imaging information and clinical factors, splenectomy was performed in 16 out of 30 patients. Five (31%) of these 16 patients were initially treated non-surgically but US findings during follow-up examinations made splenectomy necessary. Our results have shown that US remains a useful technique in identifying and quantifying initial splenic injury as well as monitoring the healing progress. Final treatment choices depend furthermore on clinical and laboratory assessments.
Görg
C
C
Department of Medicine, Philipps University, School of Medicine, Marburg, FRG.
Schwerk
W B
WB
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000000981:diagnostic imaging / Q000601:surgery; D006465:Hemoperitoneum / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013156:Splenectomy; D013161:Splenic Rupture / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography