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Splenic Rupture

Background

Although protected under the bony ribcage, the spleen remains the most commonly affected organ in blunt injury to the abdomen in all age groups. While some references occasionally document liver injuries as being more common, blunt injuries to the spleen are documented more frequently as the primary solid organ injury in the abdomen. These injuries are common in both rural and urban environments and result from motor vehicle crashes, domestic violence, sporting events, and accidents involving bicycle handlebars. See the images below.

Intra-parenchymal blush observed on helical CT sca

Intra-parenchymal blush observed on helical CT scan.

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Grade 4-5 splenic laceration on helical CT scan.

Grade 4-5 splenic laceration on helical CT scan.

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A general surgeon in a community hospital is just as likely to observe and treat a splenic injury as the full-time trauma surgeon in an American College of Surgeons (ACS) –verified Level 1 or Level 2 trauma center. For this reason, all physicians involved in emergency care, especially surgeons, whether rural or urban, must keep up-to-date on issues regarding splenic injury diagnosis, splenic salvage techniques, indications for nonoperative treatment, and potential complications arising from both operative splenectomy and nonoperative management of this important organ.

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