Management of Splenic Injury

Abstract

Traumatic splenic injury is a potentially life-threatening complication of both blunt and penetrating trauma to the abdomen and thorax. The spleen is susceptible to injury in the presence or absence of damage to surrounding viscera and can lead to haemodynamic instability and hypovolaemic shock. This review examines the classification, investigation and management of this condition with both non-operative and operative techniques.

Ultrasonography of the healing process during a 3-month follow-up after a splenic injury

“…The spleen is the second most frequently traumatized abdominal organ in the cases of blunt trauma, following the liver [ 2 , 7 ]. Because of its protected position in the left hypochondrium, the spleen is less affected by penetrating trauma than the liver and the other abdominal organs.…”

“…However, patients with splenomegaly due to anemia like the one discussed above are more vulnerable to splenic trauma. Causes of splenic trauma include motor vehicle and motorcycle collisions, assaults, falls, and many sports activities like cycling [ 2 ]. Falls onto bicycle handlebars usually affect male children and are considered to represent a serious mechanism of trauma as they may result in injuries of parenchymal organs like the spleen in 20%-37% of the cases and gastrointestinal perforation in 21% of the cases [ 3 ].…”

“…Falls onto bicycle handlebars usually affect male children and are considered to represent a serious mechanism of trauma as they may result in injuries of parenchymal organs like the spleen in 20%-37% of the cases and gastrointestinal perforation in 21% of the cases [ 3 ]. Splenic trauma is usually characterized as lacerations or hematomas and classified according to the AAST classification, on the basis of CT findings [ 2 ]. However, this grading system is poorly correlated with the patient’s outcome and the decision of surgery [ 7 ].…”

“…1 ). The splenic injury was classified as type III according to the American Association for the Surgery of Trauma (AAST) classification [ 2 ]. Conservative treatment was decided with US follow-up.…”

“…The spleen is frequently involved in both blunt and penetrating trauma, accounting for 45% of all visceral injuries [ 1 , 2 ]. Falls onto bicycle handlebars represent a common cause for splenic trauma, particularly in the paediatric population [ 3 ].…”