Laparoscopic diagnosis of subcapsular splenic hematoma in a horse

A 5-year-old Quarter Horse was examined after it developed signs of abdominal discomfort as a result of a training accident. Oral mucous membranes were pale, and capillary refill time was > 3 seconds. Hematologically, the PCV was low, and abdominocentesis yielded a serosanguineous fluid. Abdominal ultrasonography was performed and revealed a large hypoechoic mass associated with the cranial margin of the spleen. Because differentiation between subcapsular hematoma and extracapsular hematoma could not be made with certainty, further evaluation of the spleen was indicated. Abdominal laparoscopy was performed, with the horse standing, to evaluate the extent, severity, and nature of the splenic hematoma. Laparoscopic examination revealed a 7.5-cm-diameter splenic hematoma contained within the splenic capsule, confirming the diagnosis of subcapsular splenic hematoma. Abdominal laparoscopy provided excellent observation of the spleen and allowed for thorough evaluation and determination of the extent of the lesion. This information aided the clinician in reaching a definitive diagnosis and choosing between splenectomy and medical treatment.