From the Guidelines
The most common organ affected by blunt trauma is the spleen. This is due to its location under the ribcage, making it more susceptible to injury from blunt force trauma to the abdomen or chest. The spleen is a highly vascular organ, and injuries to it can result in significant bleeding, which can be life-threatening if not promptly addressed. Some key points to consider about splenic trauma include:
- The spleen is the most commonly injured solid organ in blunt abdominal trauma, contributing to worldwide trauma-associated mortality and morbidity 1.
- The management of splenic trauma has shifted towards a more conservative approach, with an emphasis on preserving splenic parenchyma and function, and current data suggests that up to 90% of patients with splenic injury can be treated non-operatively 1.
- The World Society of Emergency Surgery (WSES) has developed a classification system for splenic trauma and guidelines for management, which take into account the hemodynamic status, anatomic derangement, and associated injuries of the patient 2.
- Non-operative management (NOM) of splenic trauma is the mainstay in children, with a high success rate of splenic preservation, and is associated with reduced cost, length of hospital stay, and need for blood transfusions 2.
From the Research
Organ Affected by Blunt Trauma
- The most common organ to be affected by blunt trauma is the spleen, as stated in several studies 3, 4, 5, 6.
Reasons for Spleen Injury
- The spleen is the most frequently injured organ in adults who sustain blunt abdominal trauma, accounting for approximately 25% to 30% of all intra-abdominal injuries 5.
- Blunt trauma to the spleen is the most common cause of traumatic injury to the spleen 4.
Management of Splenic Injury
- The management of splenic injury has undergone rapid change over the last decade, with increasing emphasis on splenic salvage and non-operative management 5.
- Methods for the management of blunt splenic injury-associated bleeding include observation, splenectomy, and splenic salvage procedures through splenorrhaphy or embolization 6.
Diagnosis of Splenic Injury
- Imaging is integral in the identification of splenic injuries, both at the time of injury and during follow-up, with CT remaining the gold standard in blunt abdominal trauma 3, 5.
- Ultrasonography also plays an important role in assessing the traumatized spleen, especially in correlation with other imaging modalities 5.