Presentation
Fall from 6-foot tall wall. Bruising and tenderness of left anterior abdominal wall. Blood pressure and pulse normal.
Patient Data
An extensive area of hypoattenuation in the spleen affects the cranial portion of the spleen. This is a large splenic injury that extends from the capsule to the hilum. The more inferior portion of the spleen enhances normally and there are no areas of hyperenhancement (which would suggest extravasation or splenic pseudoaneurysm).
Moderate-volume free fluid within the peritoneal space of increased density. Features of hemoperitoneum.
The other solid organs are normal. Specifically, the pancreas is normal. Normal duodenum. No bony injury.
Case Discussion
Splenic trauma is relatively rare in children but may occur following high-energy blunt abdominal trauma. Splenic injury can be classified by determining the portions of the spleen that are affected. It is important to actively look for evidence of extravasation and pseudoaneurysm.
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