SURG
Spleen
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Aetiology: Blunt/ Penetrating injury
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Blunt trauma: most frequently injured organ
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Injury to left side- chest, flank, or abdomen
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Left lower chest & upper abdomen:
- Pain, Bruising, Tenderness
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Diagnosis:
- FAST - unstable patients
- FAST + CT-stable patients
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American Association for the Surgery of Trauma (AAST) splenic injury scale
Trauma
Splenic injury
- Most frequently injured organ in blunt trauma
- History of injury to the left side of the chest, flank, or left upper part of the abdomen
- Bruising, pain tenderness- lower chest and upper abdomen on left side
- Diagnosis: -Z
- CT in hemodynamically -stable patients
- FAST or exploratory laparotomy in an unstable patients
(Image: Splenic injury (CT scan))
Splenic injury: I-Non-surgical management (70%)
- Hemodynamically stable.
- FAST, CT scan.
- No other intra-abdominal injury requiring operation
- ICU admission for continuous monitoring.
- Serial hemoglobin.
- Repeated abdominal assessment.
- If hypotension develops - for surgery.
Splenic injury: II- Surgical management
- Hemodynamically unstable
- FAST: splenic injury, free fluid (hemoperitoneum)
- Surgery- splenectomy
- Polyvalent pneumococcal vaccine (pneumovax)