IMAGING DIAGNOSIS OF SPLENIC TRAUMA

NARRATIVE REVIEW

Abstract

INTRODUCTION: The spleen has an important role in the running of the human blood defense system, removing old red blood cells and holds a reserve of blood. However, this function can be compromised if occours an splenic trauma, that is the most commom kind of abdominal trauma, it can be classified as penetranting or blunt. The blunt splenic trauma can be caused, for example, by sporting injuries. Whilst the penetrating splenic trauma is caused by, for example, by gunshot wound. So, there is the gold standard diagnosis, the computed tomography, wich leaves room for non-operative management. OBJECTIVE: Review, identify and describe the imaging characterization of splenic traumas. METHODOLOGICAL PROCEDURES: This study can be characterized as a narrative review with emphasis on a collection of images. The databases were MEDLINE via PubMed, LILACS via BIREME, Scielo and Academic Google. The health descriptors (MeSH terms) in English are “splenic rupture”, “spleen”, “wounds and injuries” and “diagnostic imaging. Studies (clinic trials, pictorial essays, literature reviews, among others) that had images of diagnostic methods that were in accordance with the research objective and available online in full text published in the last 10 years, in english, spanish and portuguese. RESULTS AND DISCUSSION: Splenic trauma presents as an imaging finding mainly the spleen laceration, seen as a hypodense line, which may or may not be irregular. Such a condition corresponds to the splenic hematoma and hemiperitoneum, as well as the fluid adjacent to the liver and in the paracolic, related to hemorrhage. Subcapsular and parenchymal hematoma can also be seen, as well as the presence of hypo-anechoic fluid collection in the subcapsular or perisplenic space. In addition, the computed tomography has a better performance when contrast is used. CONCLUSION: The imaging diagnosis of splenic trauma should be done using preferably computed tomography, but focused assessment with sonography in trauma and ultrasonography also can be used with further confirmation by computed tomography.