Computed Tomography of Blunt Spleen Injury: A Pictorial Review

The spleen is one of the organs most frequently injured in blunt abdominal trauma. Computed tomography (CT) scanning can accurately detect splenic injury and is currently the imaging modality of choice in assessing clinically stable patients with blunt abdominal trauma. The CT features of spleen injury include lacerations, subcapsular or parenchymal haematomas, active haemorrhage, and vascular injuries. We present a pictorial review of the spectrum of CT findings for blunt splenic injuries. This article will be a useful reference for radiologists and surgeons as CT scan is widely used for the assessment of splenic injuries and contributes to the current trend towards nonsurgical management of this injury.

Esplenectomía por trauma cerrado de abdomen más paludismo vivax. A propósito de un caso / Case review: Splenectomy in a acute abdomen posterior to a Trauma

Reporte de caso de un paciente con abdomen agudo posterior a un trauma contuso en el cuál se encontró al examen de laboratorio paludismo a vivax +++. En este artículo nos permitimos demostrar el manejo clínico-quirúrgico realizado en un paciente con trauma esplénico grado 4 y paludismo vivax +++, en el hospital cantonal León Becerra de Milagro haciendo hincapié en la importancia del diagnóstico clínico y semiología quirúrgica a pesar de los limitantes en los exámenes complementarios que tenemos en nuestro centro hospitalario, en el cual TAC no está al alcance de nuestro servicio de emergencia.

This is a report about a patient with acute abdomen posterior to a blunt trauma. In the laboratory exam done to the patient it was positive for P. vivax malaria. In this article we demonstrate the clinical-surgical management on a patient with fourth degree spleen trauma and positive for P. vivax malaria at Leon Becerra Hospital in Milagro. In spite of the limitations for complementary exams such as TAC which is out of our reach at our hospital we put special emphasis on the importance of a surgical - clinical diagnosis

The Efficacy of Transcatheter Arterial Embolization(TAE) in Children With Blunt Splenic Injury

PURPOSE: To evaluate the efficacy of transcatheter arterial embolization(TAE) in children with blunt splenicinjury. MATERIALS AND METHODS: The results of transcatheter splenic arterial embolization in nine children whosuffered splenic injury after blunt abdominal trauma were retrospectively studied. This injury was demonstrated byCT, and the findings were evaluated according to the classification of Mirvis et al. ; two patients were grade 3and seven were grade 4. All were carefully observed in intensive care before embolization. TAE was performed if apatient satisfied the following criteria : (1) transfusion and/or fluid replacement required to maintainhemodynamic stability ; or (2) rapid Hb/Hct decrease ; or (3) both. Splenic function was subsequently estimatedaccording to the results of 99mTc-sulfur colloid scintigraphy and/or CT scanning. RESULT: TAE was suscessful inall nine children. Two were embolized with a coil only, three with gelfoam, and four with gelfoam and a coil.Seven were embolized in the main trunk of the splenic artery and others in both the main trunk and its branches.Splenic function was preserved in all nine children, during follow-up, none suffered rebleeding. CONCLUSION: TAEof the splenic artery can be a safe and effective nonsurgical approach to the management of blunt splenic injuryin children, and can preserve splenic function.