Grade IV splenic laceration

Case contributed by Dr Henry Knipe

Presentation

Epigastric pain. Heavy alcohol use night prior.

Patient Data

Age: 24
Gender: Female
CT

Extensive splenic lacerations extending to the hilum with areas of devascularisation. No evidence of active bleeding or pseudo-aneurysm. There is extensive haemoperitoneum throughout the abdominopelvic cavity. Cholecystectomy clips are noted along with extrahepatic and first order intrahepatic duct dilatation. Liver is uninjured. Adrenal glands, kidneys and pancreas are uninjured. Bowel is unremarkable. Lung bases are clear. No bony injury identified.

Conclusion:

AAST grade IV splenic injury with extensive haemoperitoneum.

Case Discussion

Further history obtained (after the CT) revealed a fall from 1.5 metres. Patient proceeded to successful splenic embolisation

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Case information

rID: 35109
Case created: 22nd Mar 2015
Last edited: 10th Sep 2015
System: Haematology
Tags: trauma, spleen
Inclusion in quiz mode: Included

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