J Korean Radiol Soc.  1990 Dec;26(6):1179-1185. 10.3348/jkrs.1990.26.6.1179.

Computed tomographic findings of splenic injury and correlation with treatment

• Kim DJ
• Koh JY
• Kim MS
• Hong IS
• Cho WY
• Sung KJ

• KMID: 2358774
• DOI: http://doi.org/10.3348/jkrs.1990.26.6.1179

Abstract

According to recently reported classification, 46 patients with blunt splenic trauma were evaluatedpreoperatively with CT. Injuries were graded I through IV and described as capsular or subcapsular disruptionswithout parenchymal injury(3 patients); capsular and parenchymal injuries(23 patients); injuries involving hilum(3patients); and fragmentation(17 patients). Nineteen patients were managed conservatively and 27 patients weremanaged surgically. Twelve patients(47%) out of those with Type I or Type II were managed surgically includingfive hemodynamically unstable patients and seven hemodynamically stable patients with associated injuries andunknown surgical criteria. On the other hand five hemodynamically stable patients(25%) out of those with Type IIIor Type IV were managed surgically. The amount of hemoperitoneum was graded into small, moderated and large; smallin three patients, moderate in 39 patients, and large in two patients. The amoung of hemoperitoneum in patientswith conservative treatment was moderate in 16 patients and large in one patient. And the amount of hemoperitoneumin patients with operative treatment was small in three patients, moderate in 23 patients and large in one patien.We concluded that CT was accurate method of determining the extent of splenic injury and evaluation ofhemoperitoneum, but treatment choice should be based on the hemodynamic status of patients rather than the type ofinjury or the amount of hemoperitoneum by CT.

MeSH Terms

Classification
Hand
Hemodynamics
Hemoperitoneum
Humans
Methods