Blunt splenic trauma in adults: CT-based classification and correlation with prognosis and treatment
| Autor: | Nancy O. Whitley, D. R. Gens, Stuart E. Mirvis |
|---|---|
| Rok vydání: | 1989 |
| Předmět: |
Adult
Male medicine.medical_specialty Abdominal ct Hemodynamics Spleen Wounds Nonpenetrating Severity of Illness Index Blunt splenic trauma Blunt Severity of illness Humans Medicine Radiology Nuclear Medicine and imaging Retrospective Studies business.industry Retrospective cohort study Prognosis medicine.disease Surgery medicine.anatomical_structure Abdomen Female Radiology Tomography X-Ray Computed business |
| Zdroj: | Radiology. 171:33-39 |
| ISSN: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiology.171.1.2928544 |
| Popis: | Nonsurgical management of blunt splenic injury in children is a well-established method to salvage splenic function; however, nonsurgical management of adult blunt splenic trauma remains controversial. To assess the value of preoperative abdominal CT in predicting the outcome of blunt splenic injury in adults, a CT-based injury-severity score consisting of four grades was devised and applied in 39 adult patients with blunt splenic injury as the sole or predominant intraperitoneal injury detected with preoperative CT. While patients with high grades of splenic injury generally required early surgery, eight (35%) of 23 patients with initial grade 3 or 4 injury were treated successfully without surgery, and four (29%) of 15 patients with grade 1 or 2 injury initially treated nonsurgically required delayed celiotomy (n = 3) or emergency rehospitalization. Results show that while CT remains an accurate method of identifying and quantifying initial splenic injury, as well as documenting progression or healing of critical injury, CT cannot reliably help predict the outcome of blunt splenic injury in adults. Treatment choices should therefore be based on the hemodynamic status of the patient and results of serial laboratory and bedside assessments. |
| Databáze: | OpenAIRE |
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