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Splenic rupture: Difference between revisions

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Revision as of 14:23, 19 December 2023

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'''Rupture of the spleen''' is a potentially life-threatening condition. The spleen has a rich blood supply and rupture may therefore cause severe haemorrhage, haemorrhagic [[shock]], or death.
<section begin="radiology" />'''Rupture of the spleen''' is a potentially life-threatening condition. The spleen has a rich blood supply and rupture may therefore cause severe haemorrhage, haemorrhagic [[shock]], or death.<section end="radiology" />


It’s the most frequent organ injury after [[blunt abdominal trauma]] cases, in which it occurs in 25% of cases.
It’s the most frequent organ injury after [[blunt abdominal trauma]] cases, in which it occurs in 25% of cases.
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== Clinical features ==
== Clinical features ==
Splenic rupture may cause severe intraabdominal haemorrhage, which may manifest as [[anaemia]], haemodynamic instability, or [[shock]]. There may be abdominal pain with [[peritonitis]], either diffuse or localised to the left upper quadrant. There may be symptoms of other injuries from the trauma, like rib fracture pain and shoulder pain. Due to the mechanism described above, haemorrhage may occur days or weeks after the trauma.
Splenic rupture may cause severe intraabdominal haemorrhage, which may manifest as [[anaemia]], haemodynamic instability, or [[shock]]. There may be abdominal pain with [[peritonitis]], either diffuse or localised to the left upper quadrant. There may be symptoms of other injuries from the trauma, like rib fracture pain and shoulder pain. Due to the mechanism described above, haemorrhage may occur days or weeks after the trauma.
 
<section begin="radiology" />
== Diagnosis and evaluation ==
== Diagnosis and evaluation ==
Patients who have experienced major trauma are usually examined with [[ultrasound]] as part of [[eFAST]]. If positive, the patient will be taken to surgery. [[CT]] may also be used to show the injury. On ultrasonography, blood is hypodense.
Patients who have experienced major trauma are usually examined with [[ultrasound]] as part of [[eFAST]]. If positive, the patient will be taken to surgery. [[CT]] may also be used to show the injury. On ultrasonography, blood is hypodense.
 
<section end="radiology" />
== Treatment ==
== Treatment ==
Treatment is mostly surgical, either with [[Laparoscopic surgery|laparoscopy]] or open surgery ([[laparotomy]]). Splenic surgery may cause severe intraoperative haemorrhage so it’s important to be prepared for this. Mild injuries may be treated conservatively with close follow-up.
Treatment is mostly surgical, either with [[Laparoscopic surgery|laparoscopy]] or open surgery ([[laparotomy]]). Splenic surgery may cause severe intraoperative haemorrhage so it’s important to be prepared for this. Mild injuries may be treated conservatively with close follow-up.