Splenic laceration, fracture, or injury; blunt injury to spleen
Definitions
Parenchymal injury to spleen ± capsular disruption
IMAGING
General Features
Radiographic Findings
CT Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Reporting Tips
Selected References
Di Renzo D et al: Contrast-enhanced ultrasonography (CEUS) in the follow-up of pediatric abdominal injuries: value and timing. J Ultrasound. 23(2):151-5, 2020
Gates RL et al: Non-operative management of solid organ injuries in children: an American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee systematic review. J Pediatr Surg. 54(8):1519-26, 2019
Notrica DM et al: Reimaging in pediatric blunt spleen and liver injury. J Pediatr Surg. 54(2):340-4, 2019
Stylianos S: To save a child's spleen: 50 years from Toronto to ATOMAC. J Pediatr Surg. 54(1):9-15, 2019
The American Association for the Surgery of Trauma: Injury Scoring Scale, Updated 2018. Accessed October 3, 2021. https://www.aast.org/resources-detail/injury-scoring-scale#spleen
Armstrong LB et al: Contrast enhanced ultrasound for the evaluation of blunt pediatric abdominal trauma. J Pediatr Surg. 53(3):548-52, 2018
Ntoulia A et al: Applications of contrast-enhanced ultrasound in the pediatric abdomen. Abdom Radiol (NY). 43(4):948-59, 2018
Durkin N et al: Post-traumatic liver and splenic pseudoaneurysms in children: diagnosis, management, and follow-up screening using contrast enhanced ultrasound (CEUS). J Pediatr Surg. 51(2):289-92, 2016
Ingram MC et al: Hepatic and splenic blush on computed tomography in children following blunt abdominal trauma: is intervention necessary? J Trauma Acute Care Surg. 81(2):266-70, 2016
Bansal S et al: Contrast blush in pediatric blunt splenic trauma does not warrant the routine use of angiography and embolization. Am J Surg. 210(2):345-50, 2015
Notrica DM et al: Nonoperative management of blunt liver and spleen injury in children: evaluation of the ATOMAC guideline using GRADE. J Trauma Acute Care Surg. 79(4):683-93, 2015
Polites SF et al: Benchmarks for splenectomy in pediatric trauma: how are we doing? J Pediatr Surg. 50(2):339-42, 2015
Schuster T et al: Selective angioembolization in blunt solid organ injury in children and adolescents: review of recent literature and own experiences. Eur J Pediatr Surg. 23(6):454-63, 2013
Martin K et al: The significance of pseudoaneurysms in the nonoperative management of pediatric blunt splenic trauma. J Pediatr Surg. 46(5):933-7, 2011
Safavi A et al: Traumatic pseudoaneurysms of the liver and spleen in children: is routine screening warranted? J Pediatr Surg. 46(5):938-41, 2011
Davies DA et al: What is the significance of contrast "blush" in pediatric blunt splenic trauma? J Pediatr Surg. 45(5):916-20, 2010
van der Vlies CH et al: The failure rate of nonoperative management in children with splenic or liver injury with contrast blush on computed tomography: a systematic review. J Pediatr Surg. 45(5):1044-9, 2010
Lynn KN et al: Pediatric blunt splenic trauma: a comprehensive review. Pediatr Radiol. 39(9):904-16; quiz 1029-30, 2009
Holmes JH 4th et al: The failure of nonoperative management in pediatric solid organ injury: a multi-institutional experience. J Trauma. 59(6):1309-13, 2005
Cloutier DR et al: Pediatric splenic injuries with a contrast blush: successful nonoperative management without angiography and embolization. J Pediatr Surg. 39(6):969-71, 2004
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References
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Tables
KEY FACTS
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
Splenic laceration, fracture, or injury; blunt injury to spleen
Definitions
Parenchymal injury to spleen ± capsular disruption
IMAGING
General Features
Radiographic Findings
CT Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Reporting Tips
Selected References
Di Renzo D et al: Contrast-enhanced ultrasonography (CEUS) in the follow-up of pediatric abdominal injuries: value and timing. J Ultrasound. 23(2):151-5, 2020
Gates RL et al: Non-operative management of solid organ injuries in children: an American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee systematic review. J Pediatr Surg. 54(8):1519-26, 2019
Notrica DM et al: Reimaging in pediatric blunt spleen and liver injury. J Pediatr Surg. 54(2):340-4, 2019
Stylianos S: To save a child's spleen: 50 years from Toronto to ATOMAC. J Pediatr Surg. 54(1):9-15, 2019
The American Association for the Surgery of Trauma: Injury Scoring Scale, Updated 2018. Accessed October 3, 2021. https://www.aast.org/resources-detail/injury-scoring-scale#spleen
Armstrong LB et al: Contrast enhanced ultrasound for the evaluation of blunt pediatric abdominal trauma. J Pediatr Surg. 53(3):548-52, 2018
Ntoulia A et al: Applications of contrast-enhanced ultrasound in the pediatric abdomen. Abdom Radiol (NY). 43(4):948-59, 2018
Durkin N et al: Post-traumatic liver and splenic pseudoaneurysms in children: diagnosis, management, and follow-up screening using contrast enhanced ultrasound (CEUS). J Pediatr Surg. 51(2):289-92, 2016
Ingram MC et al: Hepatic and splenic blush on computed tomography in children following blunt abdominal trauma: is intervention necessary? J Trauma Acute Care Surg. 81(2):266-70, 2016
Bansal S et al: Contrast blush in pediatric blunt splenic trauma does not warrant the routine use of angiography and embolization. Am J Surg. 210(2):345-50, 2015
Notrica DM et al: Nonoperative management of blunt liver and spleen injury in children: evaluation of the ATOMAC guideline using GRADE. J Trauma Acute Care Surg. 79(4):683-93, 2015
Polites SF et al: Benchmarks for splenectomy in pediatric trauma: how are we doing? J Pediatr Surg. 50(2):339-42, 2015
Schuster T et al: Selective angioembolization in blunt solid organ injury in children and adolescents: review of recent literature and own experiences. Eur J Pediatr Surg. 23(6):454-63, 2013
Martin K et al: The significance of pseudoaneurysms in the nonoperative management of pediatric blunt splenic trauma. J Pediatr Surg. 46(5):933-7, 2011
Safavi A et al: Traumatic pseudoaneurysms of the liver and spleen in children: is routine screening warranted? J Pediatr Surg. 46(5):938-41, 2011
Davies DA et al: What is the significance of contrast "blush" in pediatric blunt splenic trauma? J Pediatr Surg. 45(5):916-20, 2010
van der Vlies CH et al: The failure rate of nonoperative management in children with splenic or liver injury with contrast blush on computed tomography: a systematic review. J Pediatr Surg. 45(5):1044-9, 2010
Lynn KN et al: Pediatric blunt splenic trauma: a comprehensive review. Pediatr Radiol. 39(9):904-16; quiz 1029-30, 2009
Holmes JH 4th et al: The failure of nonoperative management in pediatric solid organ injury: a multi-institutional experience. J Trauma. 59(6):1309-13, 2005
Cloutier DR et al: Pediatric splenic injuries with a contrast blush: successful nonoperative management without angiography and embolization. J Pediatr Surg. 39(6):969-71, 2004
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