Grade II splenic injury

Case contribution: Dr Radhiana Hassan


  • A 13 years old man
  • Fall from motorbike
  • No loss of consciousness
  • Complaint of abdominal pain.
  • Vital signs are stable
CT scan abdomen pelvis in axial plane soft tissue window post contrast

CT findings:

  • Laceration at posterior part of the spleen measuring about 2 cm (yellow arrows)
  • Minimal parenchymal hematoma at inferior pole
  • There is associated blood collection at perihepatic, perisplenic and paracolic gutter
  • No other organ injuries.

Intraoperative findings:

  • lacerated spleen at tip about 4 cm length
  • hilar is intact
  • Contusion at tail of pancreas
  • Hemoperitoneum about 1100 cc
  • Other solid organs and bowels are normal
  • Splenectomy done

Progress of patient:

  • Failed conservative management
  • Splenectomy done
  • Blood transfusion 2pint and 1 cycle DIVC regime
  • Discharged 6 days after admission
  • Well on subsequent follow up.


  • Grade I and II splenic injury is considered minor injury.
  • Most of these injuries are treated non-operatively
  • However, these lesions associated with hemodynamic instability often must be treated with operative management as demonstrated by this case.
Author: radhianahassan