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Doppler ultrasound for the assessment of conservatively treated blunt splenic injuries: a prospective study

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

The type and need for follow-up of non-operatively managed blunt splenic injuries remain controversial. The use of Doppler ultrasound to identify post-traumatic splenic pseudoaneurysms, considered to be the main cause of “delayed” splenic rupture, has not been well described.

Patients and methods

A 5-year prospective study was performed from 2004 to 2008. All patients with blunt splenic injury diagnosed with computerized tomography, who were treated non-operatively, were included in the study. Doppler ultrasound examination was performed 24–48 h post-injury. Consecutive Doppler ultrasound examinations were done on 7, 14 and 21 days post-injury for patients diagnosed with a splenic pseudoaneurysm. Demographic and clinical data were collected. Ambulatory follow-up continued for 4 weeks after hospital discharge.

Results

A total of 38 patients were enrolled in the study. Grading of splenic injury demonstrated 19 (50%) patients with Grade I, 16 (42%) with Grade II and 3 (8%) with Grade III injuries. Two patients (5%) had pseudoaneurysms. All pseudoaneurysms underwent complete resolution within 2 weeks after diagnosis. No patients received blood products, or had angio-embolization or surgery during the study period. All patients were found to be asymptomatic and stable at the 4-week follow-up.

Conclusions

Doppler ultrasound can be an effective and a safe noninvasive modality for evaluation and follow-up of patients with blunt splenic injury. The utility and cost-effectiveness of routine surveillance requires further study.

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Authors and Affiliations

  1. Department of Surgery B, The Yitzhak Rabin Trauma Division, Tel Aviv Sourasky Medical Center, 6 Wiezmann St., Tel Aviv, 64239, Israel

    D. Soffer, O. Wiesel, M. Ben Haim & J. M. Klausner

  2. Divisions of Burns, Trauma and Critical Care, University of Miami, Miller School of Medicine, Miami, Florida, USA

    C. I. Schulman

  3. Ultrasound Division, Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel

    A. Kessler

Authors
  1. D. Soffer
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  2. O. Wiesel
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  3. C. I. Schulman
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  4. M. Ben Haim
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  5. J. M. Klausner
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  6. A. Kessler
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Correspondence to D. Soffer.

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Soffer, D., Wiesel, O., Schulman, C.I. et al. Doppler ultrasound for the assessment of conservatively treated blunt splenic injuries: a prospective study. Eur J Trauma Emerg Surg 37, 197–202 (2011). https://doi.org/10.1007/s00068-010-0044-7

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  • DOI: https://doi.org/10.1007/s00068-010-0044-7

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