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Splenic Trauma
Michael R. Aquino, MD, MHSc
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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

                                          1. 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
                                          2. Polites SF et al: Benchmarks for splenectomy in pediatric trauma: how are we doing? J Pediatr Surg. 50(2):339-42, 2015
                                          3. Dodgion CM et al: National trends in pediatric blunt spleen and liver injury management and potential benefits of an abbreviated bed rest protocol. J Pediatr Surg. 49(6):1004-8; discussion 1008, 2014
                                          4. 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
                                          5. 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
                                          6. 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
                                          7. Davies DA et al: What is the significance of contrast "blush" in pediatric blunt splenic trauma? J Pediatr Surg. 45(5):916-20, 2010
                                          8. 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
                                          9. Lynn KN et al: Pediatric blunt splenic trauma: a comprehensive review. Pediatr Radiol. 39(9):904-16; quiz 1029-30, 2009
                                          10. 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
                                          11. 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
                                          12. Lutz N et al: The significance of contrast blush on computed tomography in children with splenic injuries. J Pediatr Surg. 39(3):491-4, 2004
                                          13. Stylianos S: Evidence-based guidelines for resource utilization in children with isolated spleen or liver injury. The APSA Trauma Committee. J Pediatr Surg. 35(2):164-7; discussion 167-9, 2000
                                          14. Moore EE et al: Organ injury scaling: spleen and liver (1994 revision). J Trauma. 38(3):323-4, 1995
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          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

                                                                                  1. 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
                                                                                  2. Polites SF et al: Benchmarks for splenectomy in pediatric trauma: how are we doing? J Pediatr Surg. 50(2):339-42, 2015
                                                                                  3. Dodgion CM et al: National trends in pediatric blunt spleen and liver injury management and potential benefits of an abbreviated bed rest protocol. J Pediatr Surg. 49(6):1004-8; discussion 1008, 2014
                                                                                  4. 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
                                                                                  5. 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
                                                                                  6. 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
                                                                                  7. Davies DA et al: What is the significance of contrast "blush" in pediatric blunt splenic trauma? J Pediatr Surg. 45(5):916-20, 2010
                                                                                  8. 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
                                                                                  9. Lynn KN et al: Pediatric blunt splenic trauma: a comprehensive review. Pediatr Radiol. 39(9):904-16; quiz 1029-30, 2009
                                                                                  10. 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
                                                                                  11. 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
                                                                                  12. Lutz N et al: The significance of contrast blush on computed tomography in children with splenic injuries. J Pediatr Surg. 39(3):491-4, 2004
                                                                                  13. Stylianos S: Evidence-based guidelines for resource utilization in children with isolated spleen or liver injury. The APSA Trauma Committee. J Pediatr Surg. 35(2):164-7; discussion 167-9, 2000
                                                                                  14. Moore EE et al: Organ injury scaling: spleen and liver (1994 revision). J Trauma. 38(3):323-4, 1995