Splenic Trauma (Blunt)


Background
  1. Definition
  2. Etiology
  3. A delayed threat to life
Pathophysiology
  1. Receives 5% of cardiac output
  2. Risk increases in patients with pathologically enlarged spleens
  3. Often associated with left lower rib fractures
  4. Subcapsular hematomas may not rupture until several days after splenic injury
  5. Anatomical points
  6. Injury basics

Diagnostics
DO NOT delay surgery for diagnostics in emergent situations

  1. History
  2. Symptoms
  3. Physical exam
  4. Diagnostic testing
  5. Diagnostic imaging

Differential Diagnosis

  1. Blunt hepatic injury
  2. Blunt diaphragmatic injury
  3. Blunt pancreatic injury
  4. Blunt kidney injury
  5. Blunt intestinal injury
  6. Blunt abdominal wall trauma

Treatment

  1. ATLS as usual
  2. Specific management
  3. UNSTABLE
  4. STABLE
  5. Prophylactic antibiotics

Disposition

  1. Admit all patients
  2. Surgical consultation mandatory