Splenic trauma: Difference between revisions
| Line 18: | Line 18: | ||
==Management== | ==Management== | ||
*Observation, angiographic embolization, or surgery depending upon: | |||
**Hemodynamic status of the patient | |||
**Grade of splenic injury | |||
**Presence of other injuries and medical comorbidities | |||
*Nonoperative management | *Nonoperative management | ||
** | **Failure rate of 10-15% | ||
**Some advocate nonoperative management only if <55yr and CT injury grade less than IV | **Some advocate nonoperative management only if <55yr and CT injury grade less than IV | ||
Revision as of 14:19, 22 July 2015
Background
- Most commonly injured visceral organ in blunt trauma
Clinical Features
- LUQ pain
- Signs of shock
- Hypotension
- Left lower rib pain
- Kehr's sign
Differential Diagnosis
Abdominal Trauma
- Abdominal compartment syndrome
- Diaphragmatic trauma
- Duodenal hematoma
- Genitourinary trauma
- Liver trauma
- Pelvic fractures
- Retroperitoneal hemorrhage
- Renal trauma
- Splenic trauma
- Trauma in pregnancy
- Ureter trauma
Diagnosis
- FAST to search for free fluid
- CT scan
- Exploratory laparotomy in unstable pts
Management
- Observation, angiographic embolization, or surgery depending upon:
- Hemodynamic status of the patient
- Grade of splenic injury
- Presence of other injuries and medical comorbidities
- Nonoperative management
- Failure rate of 10-15%
- Some advocate nonoperative management only if <55yr and CT injury grade less than IV
Disposition
See Also
References
- Rosens