Splenic injury (grade III with active bleeding)

Case contributed by Dr Ayaz Hidayatov

Presentation

Middle aged woman with increased abdominal pain. History of blunt abdominal trauma few days ago. No past medical history.

Patient Data

Age: 50 years
Gender: Female

Contrast-enhanced CT shows hypodense splenic laceration within the superolateral aspect of spleen does not involve the hilum. There are hyperdense areas due to an intraparenchymal hematoma on non-contrast images. Arterial phase demonstrates focal areas of high attenuation in the splenic parenchyma due to active extravasation.

There is also hemorrhagic peritoneal free fluid (hemoperitoneum).

Findings consistent with grade 3 splenic injury.

Case Discussion

The spleen is the intra-abdominal organ most often injured as a result of blunt trauma.

The spleen is the most vascular organ, for this reason, a splenic injury is potentially life-threatening. 

On arterial phase, CT images bright white “blush” or amorphous collection within a hypodense injured solid organ indicates active bleeding. When lacerations extend through the organ capsule, hemoperitoneum results;  if the capsule is intact, a subcapsular hematoma may be demonstrated.

 

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Case information

rID: 53399
Case created: 16th May 2017
Last edited: 25th May 2017
Inclusion in quiz mode: Included

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