Computed tomography in splenic hemorrhage

Five cases of splenic hemorrhage are discussed. In the first two cases of acute splenic laceration, the perisplenic hematoma showed higher attenuation compared with splenic parenchyma, and after contrast injection attenuation of hematoma and splenic parenchyma were similar. The third case showed pericapsular and subcapsular hemorrhage at surgery. The pericapsular hematoma in the third case also showed higher attenuation. The fourth and fifth cases demonstrated subacute or chronic subcapsular hematoma of lower attenuation. The first two cases illustrate the need for noncontrast computed tomography scan in acute splenic hemorrhages, as contrast scans can obscure hematoma. Contrast study should also be done for optimal visualization, extent of hematoma, and for showing intrasplenic hematomas and contusions.