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Extra-parenchymal splenic abnormalities not vascular injury predict need for primary splenectomy

  • Margaret LauermanEmail author
  • Megan Brenner
  • Nana Simpson
  • Kathirkamanthan Shanmuganathan
  • Deborah Stein
  • Thomas Scalea
Original Article
  • 13 Downloads

Abstract

Purpose

Radiographic indications for primary splenectomy (PS) in blunt splenic injury (BSI) after radiographic diagnosis are unknown. Improved understanding of radiographic characteristics of patients requiring splenectomy will help to appropriately triage patients to PS or non-operative management (NOM).

Methods

A retrospective, single-center review was performed of BSI diagnosed with computerized tomography (CT). Patients undergoing splenectomy prior to CT diagnosis were excluded.

Results

BSI was identified in 195 patients. On logistic regression, only subcapsular hematoma presence (OR 7.521, p = 0.002) and left upper quadrant hemoperitoneum (OR 6.146, p = 0.03) were associated with need for PS, while splenic laceration length, number of pseudoaneurysms (PSA), and active contrast extravasation (NS for all) were not.

Conclusions

Need for PS is predicted by extra-parenchymal pathology in subcapsular hematoma and hemoperitoneum. Splenic vascular injuries through PSA and active contrast extravasation do not predict the need for PS and can be considered for NOM.

Keywords

Blunt splenic injury Splenic trauma Computerized tomography 

Notes

Funding

None for this project.

Compliance with ethical standards

Conflict of interest

Dr. Brenner is on the clinical advisory board of Prytime Medical Inc.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Margaret Lauerman
    • 1
    Email author
  • Megan Brenner
    • 2
  • Nana Simpson
    • 1
  • Kathirkamanthan Shanmuganathan
    • 3
  • Deborah Stein
    • 1
  • Thomas Scalea
    • 1
  1. 1.Division of Trauma and Critical Care, R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of SurgeryUniversity of California Riverside School of MedicineMoreno ValleyUSA
  3. 3.Division of Radiology, R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimoreUSA

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