Clinical and radiological presentation in patients with conserved blunt liver and splenic injuries at a tertiary care center in western India

Prashant Meshram


Background: There has been an increase in abdominal injuries following industrialisation and urbanisation. The mortality due to these injuries however has shown a declining trend worldwide. This is most probably due to early presentation, better access to health care and improved monitoring and treatment modalities.

Methods: 51 patients of conserved blunt liver and/or splenic injuries admitted in the trauma ICU of a tertiary care center were studied over a year for demographics, mode of injuries, pre- hospital delay, clinical and radiological presentation.

Results: Majority of the patients were males in the age group of 16-30 years. Vehicular accidents were the commonest mode of injuries. Liver was commonly injured. Both liver and spleen were injured in only 3 patients. 20 out of the injured 51 patients received blood transfusion and majority of them had high grade injuries. The severity of injuries was graded with both USG abdomen and CT scan of the abdomen. There was not much difference in grading of liver and splenic injuries by Ultrasound and CT scan.

Conclusions: Blunt liver and splenic injuries were commonly seen in young males. Blood transfusion was required in patients with high grade injuries. USG abdomen can be safely used to grade injuries without much discrepancy when compared to CT abdomen.


Blunt abdominal trauma, Blood transfusions, CT scan, Liver injuries, Splenic injuries, Vehicular accidents, Ultrasonography

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Slotta JE, Justinger C, Kollmar O, Schaefer T, Schilling MK. Liver injury following blunt abdominal trauma: a new mechanism-driven classification. Surg Today. 2014;44:241-6.

Patel J, Williams JS, Shmigel, Hinshaw JR. Preservation of splenic function by auto transplantation of traumatized spleen in man. Surgery. 1981;90(4):683-8.

Mucha JP, Daly RC, Farnell MB. Selective management of blunt splenic trauma. J Trauma. 1986;26(11):970-9.

Cox EF. Blunt abdominal trauma. A 5 year analysis of 870 patients requiring celiotomy. Ann Surg. 1984;199(4):467-74.

Kidd WT, Lui RC, Khoo R, Nixon J. The management of blunt splenic trauma. J Trauma. 1987;27(9):977-9.

RA Curie, Alvin L Watne, Edgar F Heiskell JR, Walter H, Gerwig JR. Blunt Abdominal trauma. Am J Surg. 1964;107:321-8.

Allan RB, Curry GJ. Abdominal trauma: A study of 297 consecutive cases. Am J Surg. 1957;93:398-404.

Falimirski ME, Provost D. Non-surgical management of solid abdominal injury in patients of over 55 years of age. AM J Surg. 2000;66(7):631-5.

Hoffmann R, Nerlich N, Muggia-Sullam M. Blunt abdominal trauma in cases of multiple trauma evaluated by USG: Study of 291 cases. J Trauma. 1992;32:452-8.

Kimura A, Otusaka T. Emergency center USG in evaluation of hemoperitoneum: A prospective study. J Trauma. 1991;31:20-34.

McKenney MG, Martin L, Lentz K, Lopez C, Sleeman D, Aristide G, et al. Thousand consecutive USG for blunt abdominal trauma. J Trauma. 1996;40:607-12.

EH Carillo, A Plazt, FB Miller. Non operative management of blunt hepatic trauma. Brit J Surg. 1998;85:416-68.

Goldstein AJ, Sclafani SJ, Kupferstein Bass I, Lewis T, Panetta T, et al. The diagnostic superiority of CT. J Trauma. 1995;25:938-46.

Nelson EW, Holliman CJ, Juell BE, Mintz S. CT in evaluation of Blunt Abdominal trauma. Am J Surg. 1983;146(6):751-4.

Matsubara TK, Fong HM, Burns CM. Computed tomography of abdomen (CTA) in management of blunt abdominal trauma. J Trauma. 1990;30:410-4.

Shweiki E, Klena J, Wood GC, Indeck M. Assessing the true risk of abdominal solid organ injury in hospitalized rib fracture patients. Assessing the true risk of abdominal solid organ injury in hospitalized rib fracture patients. J Trauma. 2001;50:684-8.

Al-Mulhim AS, Mohammad HA. Non-operative management of blunt hepatic injury in multiply injured adult patients. Surg. 2003;1:81-5.

Brasel KJ, Delisle CM, Olson CJ Borgstrom DC. Trends in the management of hepatic injury. Am J Surg. 1997;174(6):674-7.

Malhotra AK, Fabian TC, Groce MA. Blunt hepatic trauma: A paradigm shift from operative to non-operative management in 1990s. Ann of Surg. 2000;231:804-31.

Myers MD, Dent DL, Stewart RM, Gray GA, Smith DS, et al. Blunt splenic injuries: dedicated trauma surgeons can achieve a high rate of non-operative success in patients of all ages. J Trauma. 2000;200:801-5.

Parks RW, Chrysos E, Diamond P. Management of liver trauma. Br J Surg. 1999;86(9):1121-35.