Presentation
Knocked off bike by car. Minor abdominal pain 24 hours later. Normotensive. Not tachycardic.
Patient Data
Large volume free fluid within the abdomen. Normal liver, pancreatic bed and kidneys with normal vascularity.
The spleen is abnormal with focal hypoechogenicity paired with lack of vascularity.
Isolated splenic trauma with a laceration extending towards the hilum (Grade II). No evidence of extravasation. Normal pancreas, mesenteric root, liver and kidneys. Otherwise normal enhancement.
Case Discussion
Ultrasound use in trauma is potentially contentious because of its relative insensitivity to certain important findings, e.g. pseudoaneurysm.
However, in the well child, an ultrasound can be used for continued low-grade symptoms providing that any abnormality is further assessed with a CT.
In this case, a child who was well and had mild abdominal pain was confirmed to have a splenic injury and further investigations were performed.
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