Title

Splenic trauma in adults: impact of CT grading on management

UMMS Affiliation

Department of Radiology

Publication Date

6-1-1989

Document Type

Article

Subjects

Adolescent; Adult; Female; Humans; Male; Middle Aged; Prospective Studies; Retrospective Studies; Spleen; *Tomography, X-Ray Computed; Wounds, Nonpenetrating

Disciplines

Life Sciences | Medicine and Health Sciences

Abstract

The impact of computed tomographic (CT) grading of splenic injury on case management was evaluated in 64 adult patients who underwent abdominal CT within 24 hours of blunt abdominal trauma. Severity of splenic parenchymal disruption and the presence of hemoperitoneum were each graded on a scale of 0-3 (maximal total score = 6). The splenic injury was graded retrospectively (stage 1) in 29 patients and prospectively (stage 2) in 35 patients. Patients who were treated surgically had a significantly higher score than those who were treated conservatively (3.8 vs 1.9 in stage 1, 4.1 vs 1.7 in stage 2, P less than .001 for both stages). Data analysis showed that patients with a splenic score of less than 2.5 can be treated safely without surgery, while patients with a splenic score of 2.5 or more are more likely to need surgery. In the latter group of patients, CT scoring did not change the operative rate (74% vs 75%) but did prompt earlier surgical intervention in stage 2. This significantly increased the rate at which spleen-saving operations were performed (from 21% to 67%, P less than .032) and the overall rate of splenic salvage. The CT scoring system used in this study appears to be a simple, reproducible, and useful method for quantitating splenic injury in blunt abdominal trauma.

Rights and Permissions

Citation: Radiology. 1989 Jun;171(3):725-9.

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Radiology

PubMed ID

2717742