Increased risk with splenomegaly - infectious mononucleosis, liver disease, infiltrate disease, malignancy
- Lies below ribcage but commonly affected organ in blunt injury to the abdomen in all age groups.
- Seen with motor vehicle crashes, domestic violence, sporting events, and accidents involving bicycle handlebars.
- Early detection is key
- Weighs 75-150 g and is a highly vascular organ
- Filters an estimated 10-15% of total blood volume every minute.
- Can pool large reserve volumes of RBC
- Low BP, Tachycardia, Shock, LUQ pain and tenderness
- Referred pain to the left shoulder
- Occasionally symptoms can be delayed from the initial trauma
- Ensure full trauma assessment for other injuries
- FBC, U&E, LFTS, Cross match
- CXR: perforation, pleural effusion, haemothorax
- USS : may identify splenic haematoma
- CT Abdomen: imaging modality of choice
- ABCDE and IV fluids and Surgical consult and full trauma assessment
- Consider reversing any anticoagulation or treating coagulopathy
- Emergency splenectomy as needed. Small tears can be repaired.
- Life long protection related to risks of infection.