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

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

Research output: Contribution to journalArticle

2 Scopus citations

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

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

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