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

D. Soffer, O. Wiesel, Carl I Schulman, M. Ben Haim, J. M. Klausner, A. Kessler

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish
Pages (from-to)197-202
Number of pages6
JournalEuropean Journal of Trauma and Emergency Surgery
Volume37
Issue number2
DOIs
StatePublished - Apr 1 2011

Fingerprint

Doppler Ultrasonography
Nonpenetrating Wounds
Prospective Studies
False Aneurysm
Wounds and Injuries
Splenic Rupture
Cost-Benefit Analysis
Tomography
Demography

Keywords

  • Abdominal trauma
  • Spleen pseudoaneurysm
  • Splenic trauma
  • Vascular trauma

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Critical Care and Intensive Care Medicine
  • Emergency Medicine

Cite this

Doppler ultrasound for the assessment of conservatively treated blunt splenic injuries : A prospective study. / Soffer, D.; Wiesel, O.; Schulman, Carl I; Haim, M. Ben; Klausner, J. M.; Kessler, A.

In: European Journal of Trauma and Emergency Surgery, Vol. 37, No. 2, 01.04.2011, p. 197-202.

Research output: Contribution to journalArticle

@article{c6cbe498449a439ab62d4dcf164b3b92,
title = "Doppler ultrasound for the assessment of conservatively treated blunt splenic injuries: A prospective study",
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.",
keywords = "Abdominal trauma, Spleen pseudoaneurysm, Splenic trauma, Vascular trauma",
author = "D. Soffer and O. Wiesel and Schulman, {Carl I} and Haim, {M. Ben} and Klausner, {J. M.} and A. Kessler",
year = "2011",
month = "4",
day = "1",
doi = "10.1007/s00068-010-0044-7",
language = "English",
volume = "37",
pages = "197--202",
journal = "Unfallchirurgie",
issn = "0340-2649",
publisher = "Urban und Vogel",
number = "2",

}

TY - JOUR

T1 - Doppler ultrasound for the assessment of conservatively treated blunt splenic injuries

T2 - A prospective study

AU - Soffer, D.

AU - Wiesel, O.

AU - Schulman, Carl I

AU - Haim, M. Ben

AU - Klausner, J. M.

AU - Kessler, A.

PY - 2011/4/1

Y1 - 2011/4/1

N2 - 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.

AB - 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.

KW - Abdominal trauma

KW - Spleen pseudoaneurysm

KW - Splenic trauma

KW - Vascular trauma

UR - http://www.scopus.com/inward/record.url?scp=79953786816&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79953786816&partnerID=8YFLogxK

U2 - 10.1007/s00068-010-0044-7

DO - 10.1007/s00068-010-0044-7

M3 - Article

AN - SCOPUS:79953786816

VL - 37

SP - 197

EP - 202

JO - Unfallchirurgie

JF - Unfallchirurgie

SN - 0340-2649

IS - 2

ER -