Presentation
Loss of consciousness, bruising of lower chest, and upper abdomen
Patient Data
There is evidence of acute splenic injury in the form of lacerations involving the midpole of the spleen for a maximum depth of 3.2 cm, parenchymal hematoma and subcapsular hematoma.
Remnant portions of the spleen show normal enhancement.
No active hemorrhage is noted.
Mild free fluid is noted in the pelvis.
Case Discussion
Splenic trauma is relatively rare in children. It may be seen in high-energy blunt-force trauma. However, it is seen in relatively low-energy trauma too.
Splenic injury can be classified by determining the portions of the spleen that are affected.
The AAST guidelines recommend dual arterial/portal venous phase imaging for evaluation of a vascular injury of the liver, spleen, and kidney.
It is important to actively look for evidence of extravasation and pseudoaneurysm.
The patient was managed conservatively.
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