Iatrogenic splenic injury in postoperative patients: a series of case reports

The purpose of this study was to report case studies of iatrogenic splenic injuries on computed tomography (CT) in symptomatic postsurgical patients. The medical records and CT studies of all patients with injury to the spleen after abdominal surgery were reviewed. CT was performed in the postoperative period, urgently in all patients. Unsuspected splenic injuries were found on CT performed in the early postoperative period in seven symptomatic patients (five women and two men, age range 21-81 years) after various abdominal surgical procedures. Injuries as detected on CT included splenic infarct in five, subcapsular hematoma in two, and laceration of the spleen in one. These findings were the only abnormal abdominal findings in four of the patients and were probably the source of the postoperative abdominal pain and fever. Splenic injury is a rare complication of abdominal surgery. It is often the radiologist who diagnoses the injury, and awareness of this possible complication can obviate further investigations.