title: Clinical outcome of active extravasation in splenic trauma.
abstract: The purpose of this study was to determine the necessity for splenectomy in patients with active extravasation on contrast enhanced CT secondary to splenic trauma. We reviewed cases of splenic injury and classified these according to the American Association for the Surgery of Trauma (AAST) grading scale. The presence of active extravasation and associated injuries was assessed. Chart review was then performed to determine age, sex, mechanism of injury, indications for splenectomy, and clinical outcome. Of 82 cases evaluated, 12 grade I, 15 grade II, 30 grade III, 17 grade IV, and 8 grade V injuries were present. Eighteen patients were actively extravasating. Of extravasating patients, 13 eventually underwent open splenectomy or embolization and five (27.8%) were managed expectantly with success. Of grade IV injuries, 9/17 showed active extravasation, of which six underwent splenectomy. Of grade V injuries, 3/8 showed active extravasation, and all three underwent intervention. Splenectomy may not be necessary in appropriately chosen patients with active extravasation from the spleen in blunt abdominal trauma.
authors.affiliation: Department of Radiology, William Beaumont Hospital, 3601 W. Thirteen Mile Road, Royal Oak, MI, 48073, USA. caseyrhodesmd@hotmail.com
authors.forename: Casey A
authors.initials: CA
authors.lastname: Rhodes
authors.forename: David
authors.initials: D
authors.lastname: Dinan
authors.forename: S Zafar
authors.initials: SZ
authors.lastname: Jafri
authors.forename: Gregory
authors.initials: G
authors.lastname: Howells
authors.forename: Kathleen
authors.initials: K
authors.lastname: McCarroll
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging* / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery
chemical_list: D003287:Contrast Media