Splenic trauma
Background
- Most commonly injured visceral organ in blunt trauma
Clinical Features
- LUQ pain
- Signs of shock
- Hypotension
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 floating fluid
- CT scan
- Exploratory laparotomy in unstable pts
Management
- Nonoperative management of splenic injuries has failure rate of 10-15%
- Some advocate nonoperative management only if <55yr and CT injury grade less than IV