PP 105. Splenic Rupture 15 Days after Blunt Abdominal Trauma: True Imaging?

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U. Mehmet Meral, O. Hancerliogullari, T. Ilica

16:30 - 16:36h at Margrit Room

Categories: Emergency Surgery, Poster Session

Session: Poster II (P3) - Emergency / Thoracic Surgery

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Background
Splenic injury, is the most frequent solid organ injury in blunt abdominal trauma patients admitted to the emergency room.

Material and Methods
21 year-old man was admitted to first step hospital then to our second step hospital with general body trauma as a result of assault. He was complaining headache, right lower quadrant abdominal pain. Because of his maxillofacial and cranial injury he was sent to third step hospital for CT scan. Urinary ultrasound(US) and non-contrast abdominal CT had been reported as normal. The third step hospital sent the patient home with reporting that there is no pathologies requiring emergency treatment.

Result
15th day after trauma,in the morning, the patient was brought to emergency, with hypotension, tachycardia, abdominal tenderness. Fast US shown that free fluid in all quadrants and laseration in 0the spleen. Splenectomy procedure performed immediately and he was discharged without any problem.

Conclusion
In retrospective evaluation; the patient had splenic injury during the first application, when westudied on the third step hospital's CT scans carefully. In general body traumas which are being evaluated by second or third step hospitals, if possible,we must image the abdominal solid organs and evaluate the images by a senior radiolog for their possible injuries. A great amount of splenic injuries may recover by onlay supportive treatment and movement restricted hospitalization if there is only grade 1-2 laseration and subcapsuler hematoma. We think that effective imaging may decrease possible organ failures misdiagnosis and possible legal issues due to splenectomy like our patient.