Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Updated: Dec 15 2021

Splenic Laceration / Rupture

Images
https://upload.medbullets.com/topic/121859/images/splenicrupture.jpg
  • Snapshot
    • A 33-year-old man is brought to a trauma center after a motor vehicle accident. He reports a lot of pain in his chest and his abdomen. Physical exam shows multiple rib fractures on the left side. His vitals show that he is hypotensive even after several liters of crystalloid fluids. A FAST exam shows free fluid in the perisplenic space. He is taken urgently into the operating room for an exploratory laparotomy.
  • Introduction
    • Overview
      • splenic injury can result from trauma or nontraumatic causes
        • treatment is usually surgical in a hemodynamically unstable patient
  • Epidemiology
    • Risk factors
      • diseases causing splenomegaly
        • infectious mononucleosis
        • dengue fever
        • leukemia/lymphoma
        • malaria
        • malignancies
      • penetrating trauma
      • blunt trauma
      • left-sided rib fracture
  • ETIOLOGY
    • Pathogenesis
      • functions of the spleen
        • helps fight infection by producing antibodies and other key immune mediators
        • recycles old red blood cells
        • stores platelets and white blood cells
  • Presentation
    • History
      • trauma
    • Symptoms
      • common symptoms
        • location
          • left upper quadrant pain
          • left shoulder pain (Kehr sign)
          • diffuse abdominal pain
    • Physical exam
      • inspection
        • abdominal bruising
        • tachycardia
        • hypotension
        • shock
      • provocative tests
        • peritoneal signs
          • guarding
          • rigidity
  • Imaging
    • Abdominal ultrasound
      • FAST exam
        • focused abdominal sonography for trauma
      • indications
        • at bedside for all patients
      • findings
        • intra-abdominal free fluid
    • CT of abdomen
      • indications
        • hemodynamically stable patients with history of blunt abdominal trauma
        • to rule out splenic injury
      • findings
        • splenic bleeding
        • splenic injury
        • pseudoaneurysm
  • Studies
    • Serum labs
      • may have anemia
      • may have leukocytosis
  • Differential
    • Splenic abscess
      • key distinguishing factor
        • often in immunocompromised patients and IV drug users
        • fever, leukocytosis, and left upper quadrant pain
  • Treatment
    • Medical
      • close monitoring and serial abdominal exams
        • indications
          • hemodynamically stable patients
    • Surgical
      • exploratory laparotomy with possible splenectomy
        • indications
          • hemodynamically unstable
          • complete rupture
      • endovascular embolization
        • indications
          • hemodynamically stable
          • incomplete rupture
  • Complications
    • Infection
    • Acute respiratory distress syndrome
    • Pancreatitis
Card
1 of 0
Question
1 of 2
Private Note