Initial multidetector computed tomography of blunt splenic injury: Impact on manage

Abstract

Purpose: This study aimed to assess the role of MDCT in evaluation and management of blunt splenic injury. Patients and methods: We retrospectively traced clinical data of patients who underwent MDCT for suspected blunt traumatic intra-abdominal injuries and were admitted in general surgery department of Nizwa Hospital, Oman, during period from March 2012 to February 2013. 44 patients were found to have splenic injuries that were verified either during laparotomy or with clinical notes during hospital stay. The initial MDCT findings were correlated with the final diagnosis and management of the patients. Results: The 44 splenic injuries were classified according to American Association for Surgery of Trauma (AAST) grading scales, and 32 of them (72.7%) underwent non-operative management. Of the 7 patients with contrast material extravasation (CME), all underwent spleen-related laparotomy (100%) and demonstrated active bleeding during surgery. Only 5 of the remaining 37 patients without CME (13.5%) required spleen-related laparotomy. The difference was statistically significant (p < 0.01). Conclusion: MDCT evaluation of blunt splenic injuries provides accurate diagnosis which is helpful in determining the proper plan for successful management strategy.

Keywords

• Blunt trauma
• Splenic injury
• Contrast material extravasation
• Non-operative management
• Multidetector CT