Case contribution: Dr Radhiana Hassan
Clinical:
- A 13 years old man
- Fall from motorbike
- No loss of consciousness
- Complaint of abdominal pain.
- Vital signs are stable
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.
Discussion:
- 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.
