Splenic Injury in Blunt Abdominal Trauma

The spleen is the most frequently injured organ in blunt abdominal trauma. Injuries can range from subcapsular hematoma to splenic fracture. On imaging studies a subcapsular hematoma will compress the lateral margin of the spleen. A laceration appears as a hypodense linear cleft through the splenic parenchyma. A fracture is a laceration that extends through the splenic hilum, isolating a fragment of splenic tissue.

The above CECT demonstrates a large subcapsular splenic hematoma causing compression and medial deviation of the spleen. A focus of high density within this hematoma represents active contrast extravasation. Angiogram of the splenic artery shows a blush of contrast near the inferior splenic pole which was successfully embolized with Gelfoam.

REFERENCES

Roberts JL, Dalen K, Bosanko CM, et al. CT in abdominal and pelvic trauma. Radiographics 1993;13:735-52.