Nonoperative management of splenic injury: are follow-up computed tomographic scans of any value?
OBJECTIVE
To determine the value of follow-up abdominal computed tomography in patients with splenic trauma managed nonoperatively.


METHODS
Retrospective chart review.


METHODS
A total of 108 consecutive patients with splenic injuries treated at a single institution from 1990 to 1996 were studied. All admission and follow-up computed tomographic (CT) scans were reviewed by the authors.


RESULTS
Initial management was surgical in 35 patients (32%) and intentionally nonoperative in 73 patients (68%). Nonoperative management was successful in 45 of 49 adults (92%) and 21 of 24 children(88%). Sixty-two follow-up abdominal CT scans were obtained in 49 patients. Information that affected management was evident on only one follow-up CT scan performed in the absence of clinical indications. Potential savings in hospital and physician charges for routine follow-up CT scans in this study were $54,302.00.


CONCLUSIONS
Follow-up abdominal CT scans are not routinely necessary in patients with splenic injuries managed nonoperatively.
Thaemert
B C
BC
Department of Surgery, Gundersen Lutheran, La Crosse, Wisconsin 54601, USA.
Cogbill
T H
TH
Lambert
P J
PJ
D000007:Abdominal Injuries / Q000000981:diagnostic imaging / Q000191:economics / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed / Q000191:economics; D016896:Treatment Outcome