injury Flashcards
functions of spleen
pitting culling immunologic erythrocyte production platelet reservoir iron utilisation
causes of splenic rupture
rta blunt penetrating or stabbing injuries fracture of ribs hemothorax malaria infectious mononucleosis tropical splenomagaly
types of splenic injury
subcapsular hematoma clean incised wounds lacerated wound splenic hilar injury ass with other organ injuries
splenic injury presentation
signs of shock hemorrhage pain tenderness abd rigidity in left upper quadrant abdominal distension ballance sign kehrs sign delayed presesntation pseudoaneurysm
ballance sign
dullness without shifting due to clotted blood
in left flank
kehr s sign
pain in left shoulder 15 mins after foot end elevation
clot collected under left side of diaphragm irritating phrenic nerve
latent peroid of bandet
time period btw injury and presentation
blood clot tem seals off the bleedng which then get dislodged
saegessers tender point
ompression of phrenic point (along the border of the sternocleidomastoid muscle, 2-4 cm above the clavicle) causes sudden contraction of homolateral hemidiaphragm and severe pain along the lateral border of rectus abdominis muscle. It indicates a rupture or intracapsular bleeding of the spleen.
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investigation splenic rupture
us hb pcv blood grp cross matching ct xray dpl angiogram
plain xray findings in splenic rupture
obliteration of splenic outline obliteration of psoas shadow indentation of fundic gas shadow fracture of lower ribs elevation of left side of diaphragm free fluid ntw coils of intestine
dpl
subumbilical incision
1l of crystalloid
dpl significant features
gross blood of 10 ml >100000/mm3 rbc >500/mm3 wbc bile bacteria or food fibres amylase > 175 units/dl
complications of splenic rupture
blood loss dic spsis splenic artery pseudoaneurysm splenic arteriovenous fistula ass organ injuries
splenic organ in jury scale
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