Splenic injury: sonographic investigation

We report on sonographic findings in 30 patients with traumatic (n = 13) or non-traumatic (n = 17) splenic injury. An ultrasound (US)-based injury-severity-score consisting of three grades was devised and retrospectively applied in all patients. Initial sonographic abnormalities included: Intraperitoneal fluid (n = 10), perisplenic fluid (subcapsular hematoma) (n = 13), intrasplenic fluid (n = 10), splenic lacerations (n = 7) and intrasplenic flow phenomena diagnosed via Doppler-Ultra-sound (n = 3). The final diagnoses were splenic injury due to acute blunt traumatic episode (n = 9), chronic traumatic episode (n = 2), infectious mononucleosis (n = 2), splenic infarction (n = 14), and various causes (n = 3). On the basis of both imaging information and clinical factors, splenectomy was performed in 16 out of 30 patients. Five (31%) of these 16 patients were initially treated non-surgically but US findings during follow-up examinations made splenectomy necessary. Our results have shown that US remains a useful technique in identifying and quantifying initial splenic injury as well as monitoring the healing progress. Final treatment choices depend furthermore on clinical and laboratory assessments.