Presentation
Slid off motorbike at 30 mph. Tender left upper quadrant. Guarding.
Patient Data
There is an intraparenchymal hematoma/laceration measuring > 5 cm which extends to the splenic hilum. Further splenic laceration noted inferiorly. Trace of perisplenic hematoma and free fluid in the pelvis. The overall appearances are in keeping with a grade 3 splenic injury in accordance with the American Association for the Surgery of Trauma (AAST) splenic injury grading.
No bone fractures or injury to other organs. Chest was clear.
Splenic Injury grading Illustration in accordance with The American Association for the Surgery of Trauma
Case Discussion
Splenic injuries are categorized in accordance with The American Association for the Surgery of Trauma (AAST) splenic injury grading. The following points are used to classify splenic injuries.
- subcapsular hematoma
- intraparenchymal hemorrhage
- laceration depth
- hilar vascular injury
- shattered Spleen
Our case was discussed with the local trauma unit and treated conservatively.
Case also contributed by Dr H Godfrey.
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