CT appearance of the spleen following conservative management of traumatic injury

Abstract

Objective: To describe the long-term changes in the traumatized spleen following conservative management in pediatric patients. Methods: Between 1991 and 1997, 92 children were imaged with splenic trauma. The study population includes the 25 boys and 11 girls with follow-up computed tomography (CT) imaging at our institution. The follow-up CT studies were evaluated to determine the evolution of splenic injury. Results: On initial CT there were 6 grade I, 12 grade II, 9 grade III, and 9 grade IV–V splenic injuries. In follow-up 11 spleens were normal (30 %), including at least one in each grade of severity of injury. Splenic abnormalities were identified on follow-up in 25 children. These findings comprised clefts in 8 children, small cysts in 4, and devascularized segments involving less than 1 cm 3 in 6, 1–2 cm 3 in 2, and 2–4 cm 3 in 5 children. Conclusions: All grades of splenic injury can resolve completely on subsequent CT imaging. In this series 30 % of patients had a normal follow-up CT. The most common persistent abnormalities included clefts and devascularized areas less than 4 cm 3 .