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Jalal JalalShokouhi-M.D. jalaljalalshokouhi@hotmail.com Spleen trauma in adults
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The spleen is the organ that is most frequently injured by blunt abdominal trauma. The extent of the injury can range from subcapsular hemorrhage and parenchymal contusion, to a parenchymal laceration (with or without capsular injury), or a complete splenic rupture. The detection of a subcapsular hemorrhage is important
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because there is the potential of a lifethreatening hemorrhage in the event of a capsular rupture. Injury to the vascular pedicle leads to splenic infarcts of variable extent. CT has greater than 95%sensitivity in the detection of splenic injuries and is indicated whenever ultrasound findings are inconclusive.
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Even if a parenchymal defect cannot be directly visualized, the detection of perisplenic blood clots (so called sentinel clots, patchy hyperattenuating structures with CT numbers > 60 HU as compared to 35-45 HU of a hemoperitoneum) provides an indirect sign of parenchymal injury.
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Faint focal hyperenhancing regions in an otherwise homogenous splenic parenchyma may be an indicator of laceration and are as- 'sociated with an increased risk of delayed rupture. Strongly hyperenhancing regions suggest a traumatic false aneurysm. Splenic laceration may be mimicked by beam-hardening or streak artifacts due to ribs, an air-contrast interface in the stomach, nasogastric tubes, or monitor material.
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The streaks usually extent beyond the splenic parenchyma. Fissures in a lobulated spleen should not be mistaken for a splenic laceration or rupture. An over-distended stomach compressing the medial border of the spleen may obscure a small laceration.
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Splenic artery aneurysm
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Splenic hemorrhage
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Hemorrhage and laceration, fracture
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Peri-splenic hematoma or fluid and tear
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Laceration and intra peritoneal fluid or hemorrhage
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Intera peritoneal fluid or blood,splenic fracture
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MRI of spleen fracture
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Tumor or fracture
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Infarction, tumor, rupture
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Splenic explosion
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Splenic fracture
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Splenomegaly, partial tear, fluid and plural effusion
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Splenic hematoma
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Splenic fracture Spleen
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Pleural and pulmonary reactions during splenic rupture
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