Incidence of splenic abscess after conservative management of blunt splenic injury: a cross-sectional study

Milad, Nader M.; Nashed, George A.F.; Shenoda, Shenoda S.; Ghobashy, Ahmed M.

doi:10.4103/ejs.ejs_71_22

Incidence of splenic abscess after conservative management of blunt splenic injury: a cross-sectional study

Authors

Abstract

Background
The spleen and liver are the most frequently injured solid organs in blunt trauma of the abdomen. Motor car accidents are the leading cause of injury. Splenic abscess is one of the delayed complications after splenic trauma. It is not a common clinical problem. However, if not diagnosed, splenic abscess has a very high mortality rate.
Methods
This observational cross-sectional study was conducted at our Hospital Emergency Department. All patients with isolated blunt splenic trauma who were hemodynamically stable and managed conservatively were included in the study. This study was applied on 74 patients; four patients were dropped out during follow-up and two patients were operated upon and excluded from the study. Sixty-eight patients were included in this study and were managed conservatively after splenic injury.
Results
Follow-up computed tomography (CT) with intravenous contrast was performed to all included 68 patients 1 month after initial admission date, aiming to detect splenic abscess. In the presence of warning symptoms like persistent left hypochondrial pain and fever, follow-up CT was done earlier after proper clinical evaluation. Two (2.9%) cases out of 68 patients had splenic abscess. Their initial CT abdomen showed grade III splenic injury according to the American Association for Surgery of Trauma.
Conclusions
Follow-up CT abdomen with intravenous contrast is recommended for all patients with grade III or more splenic injury who underwent conservative management of splenic trauma, especially who had persistent fever and left hypochondrial pain.

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