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Case Reports in Medicine
Volume 2010, Article ID 762493, 4 pages
http://dx.doi.org/10.1155/2010/762493
Case Report

Subtle Radiological Features of Splenic Avulsion following Abdominal Trauma

1Department of Paediatric Surgery, Sheffield Children's Hospital NHS Foundation Trust, Western Bank, Sheffield S10 2TH, UK
2Department of Paediatric Radiology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield S10 2TH, UK

Received 14 August 2010; Accepted 19 October 2010

Academic Editor: Aaron S. Dumont

Copyright © 2010 S. A. Rehim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Splenic trauma in children following blunt abdominal injury is usually treated by nonoperative management (NOM). Splenectomy following abdominal trauma is rare in children. NOM is successful as in the majority of instances the injury to the spleen is contained within its capsule or a localised haematoma. Rarely, the spleen may suffer from an avulsion injury that causes severe uncontrollable bleeding and necessitates an emergency laparotomy and splenectomy. We report two cases of children requiring splenectomy following severe blunt abdominal injury. In both instances emergency laparotomy was undertaken for uncontrollable bleeding despite resuscitation. The operating team was unaware of the precise source of bleeding preoperatively. Retrospective review of the computed tomography (CT) scans revealed subtle radiological features that indicate splenic avulsion. We wish to highlight these radiological features of splenic avulsion as they can help to focus management decisions regarding the need/timing for a laparotomy following blunt abdominal trauma in children.