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Splenic Injury Updated 12/2010

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BASICS

  • Description
  • Etiology

DIAGNOSIS

  • Signs and Symptoms
  • Essential Workup
  • Tests
  • Differential Diagnosis

TREATMENT

  • Pre-hospital
  • Initial Stabilization
  • ED Treatment
  • In-patient Considerations
The following is an excerpt....
BASICS
Description
  • The spleen is formed by reticular and lymphatic tissue and is the largest lymph organ.
  • The spleen lies in the left upper quadrant (LUQ) between the fundus of the stomach and the diaphragm.
Etiology
  • The spleen is the most commonly injured intra-abdominal organ:
    • In nearly 2/3 of cases, it is the only damaged intraperitoneal structure
  • Motor-vehicle accidents (auto–auto, pedestrian–auto) are the major cause (50–75%), followed by blows to the abdomen (15%) and falls (6–9%)
  • Mechanism of injury and kinematics are important factors in evaluating patients for possible splenic injury.
  • Splenic injuries are graded by type and severity of injury:
    • Grade I:
      • Hematoma: Subcapsular, <10% surface area
      • Laceration: Capsular tear, <1 cm in parenchymal depth
    • Grade II:
      • Hematoma: Subcapsular, 10 ...

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