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Delayed Splenic Rupture; Normal Appearing Spleen on the Initial Multidetector Computed Tomography (MDCT) Can Sometimes Be Misleading

INTRODUCTION: Delayed splenic rupture (DSR) is an unusual outcome following blunt abdominal trauma. Although DSR is defined as bleeding more than 48 hours after blunt trauma in a previously hemodynamically stable patient, a review of the reported cases in the literature shows that in almost all of t...

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Autores principales: Hamidian Jahromi, Alireza, Migliaro, Matias, Romano, Melisa, Sangster, Guillermo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kowsar 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292018/
https://www.ncbi.nlm.nih.gov/pubmed/28184357
http://dx.doi.org/10.5812/traumamon.24465
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author Hamidian Jahromi, Alireza
Migliaro, Matias
Romano, Melisa
Sangster, Guillermo
author_facet Hamidian Jahromi, Alireza
Migliaro, Matias
Romano, Melisa
Sangster, Guillermo
author_sort Hamidian Jahromi, Alireza
collection PubMed
description INTRODUCTION: Delayed splenic rupture (DSR) is an unusual outcome following blunt abdominal trauma. Although DSR is defined as bleeding more than 48 hours after blunt trauma in a previously hemodynamically stable patient, a review of the reported cases in the literature shows that in almost all of the cases the initial CT imaging revealed some form of damage to the spleen. CASE PRESENTATION: Here we describe an extremely rare condition in a case that presented with a DSR following blunt trauma and had a normal appearing spleen in the initial post trauma MDCT scan. CONCLUSIONS: DSR is a serious consequence of trauma and is associated with a significantly higher mortality rate compared with the overall mortality for acute splenic injuries. A High index of suspicion along with the liberal serial utilization of the imaging studies are the essential elements for early detection of DSR. We propose that DSR be considered as a differential diagnosis in patients presenting with hemodynamic instability late post trauma, even when the immediate post trauma MDCT scan has shown a normal appearing spleen. We suggest that every patient with a high impact injury or injuries to peri-splenic organs should have a repeat MDCT scan 2 - 3 days post trauma or before the patients is discharged from hospital.
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spelling pubmed-52920182017-02-09 Delayed Splenic Rupture; Normal Appearing Spleen on the Initial Multidetector Computed Tomography (MDCT) Can Sometimes Be Misleading Hamidian Jahromi, Alireza Migliaro, Matias Romano, Melisa Sangster, Guillermo Trauma Mon Case Report INTRODUCTION: Delayed splenic rupture (DSR) is an unusual outcome following blunt abdominal trauma. Although DSR is defined as bleeding more than 48 hours after blunt trauma in a previously hemodynamically stable patient, a review of the reported cases in the literature shows that in almost all of the cases the initial CT imaging revealed some form of damage to the spleen. CASE PRESENTATION: Here we describe an extremely rare condition in a case that presented with a DSR following blunt trauma and had a normal appearing spleen in the initial post trauma MDCT scan. CONCLUSIONS: DSR is a serious consequence of trauma and is associated with a significantly higher mortality rate compared with the overall mortality for acute splenic injuries. A High index of suspicion along with the liberal serial utilization of the imaging studies are the essential elements for early detection of DSR. We propose that DSR be considered as a differential diagnosis in patients presenting with hemodynamic instability late post trauma, even when the immediate post trauma MDCT scan has shown a normal appearing spleen. We suggest that every patient with a high impact injury or injuries to peri-splenic organs should have a repeat MDCT scan 2 - 3 days post trauma or before the patients is discharged from hospital. Kowsar 2016-03-20 /pmc/articles/PMC5292018/ /pubmed/28184357 http://dx.doi.org/10.5812/traumamon.24465 Text en Copyright © 2016, Trauma Monthly http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
spellingShingle Case Report
Hamidian Jahromi, Alireza
Migliaro, Matias
Romano, Melisa
Sangster, Guillermo
Delayed Splenic Rupture; Normal Appearing Spleen on the Initial Multidetector Computed Tomography (MDCT) Can Sometimes Be Misleading
title Delayed Splenic Rupture; Normal Appearing Spleen on the Initial Multidetector Computed Tomography (MDCT) Can Sometimes Be Misleading
title_full Delayed Splenic Rupture; Normal Appearing Spleen on the Initial Multidetector Computed Tomography (MDCT) Can Sometimes Be Misleading
title_fullStr Delayed Splenic Rupture; Normal Appearing Spleen on the Initial Multidetector Computed Tomography (MDCT) Can Sometimes Be Misleading
title_full_unstemmed Delayed Splenic Rupture; Normal Appearing Spleen on the Initial Multidetector Computed Tomography (MDCT) Can Sometimes Be Misleading
title_short Delayed Splenic Rupture; Normal Appearing Spleen on the Initial Multidetector Computed Tomography (MDCT) Can Sometimes Be Misleading
title_sort delayed splenic rupture; normal appearing spleen on the initial multidetector computed tomography (mdct) can sometimes be misleading
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292018/
https://www.ncbi.nlm.nih.gov/pubmed/28184357
http://dx.doi.org/10.5812/traumamon.24465
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