Modern management of splenic trauma

Summary points Initial resuscitation, diagnostic evaluation, and management of the trauma patient is based on protocols from Advanced Trauma Life Support (ATLS) Further management of splenic injury depends on the haemodynamic stability of the patient Splenic injury is graded (I through V) depending...

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Bibliographic Details
Published in:BMJ (Online) 2014-04, Vol.348 (apr02 3), p.g1864-g1864
Main Authors: Hildebrand, D R, Ben-sassi, A, Ross, N P, Macvicar, R, Frizelle, F A, Watson, A J M
Format: Article
Language:English
Subjects:
Abdomen
CLINICAL REVIEW
Embolization, Therapeutic
Humans
Injury Severity Score
Spleen
Spleen - blood supply
Spleen - injuries
Splenectomy
Trauma
Trauma centers
Ultrasonic imaging
Wounds, Nonpenetrating - diagnosis
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Summary:Summary points Initial resuscitation, diagnostic evaluation, and management of the trauma patient is based on protocols from Advanced Trauma Life Support (ATLS) Further management of splenic injury depends on the haemodynamic stability of the patient Splenic injury is graded (I through V) depending on the extent and depth of splenic haematoma and/or laceration identified on computed tomography scan Low grade splenic injuries (I, II, and III) are suitable for non-operative management, although more recent evidence suggests that higher grades (IV and V) may also be suitable with the adjunct of angioembolisation Early use (25% spleen) V Laceration Completely shattered spleen Vascular Hilar vascular injury which devascularised spleen What happens when a splenic injury is diagnosed? In a prospective audit, no alteration in clinical management was made on the basis of repeat inpatient or outpatient imaging, 19 and a recent survey of American clinicians has shown no consensus regarding the duration of in-hospital monitoring and the timing of mobilisation and return to full activitie
ISSN:0959-8138
1756-1833
1756-1833
DOI:10.1136/bmj.g1864