Splenic rupture

Question 1

What causes a splenic rupture?

Answer 1

Usually due to secondary to abdominal trauma, blunt trauma usually, but can be iatrogenic

Question 2

What are clinical features of a splenic rupture?

Answer 2

abdominal pain, hypovolaemc shock, left upper quadrant tenderness, radiating to the left shoulder (Kehr sign)

Question 3

What investigations would you do for a splenic rupture?

Answer 3

if unstable immediate laparotomy, is stable urgent CT abdomen pelvis with IV contrast,

Question 4

How is splenic trauma graded?

Answer 4

American association for the surgery of trauma splenic injury scale

Question 5

What is the management for a splenic rupture?

Answer 5

assessed, resuscitated, urgent laparotomy, bed rest, repeat scans, prophylactic vaccinations against strep pneumonia, haemophilius influenza and meningococcus

Question 6

What are the complications of conservative treatment for splenic infarct?

Answer 6

ongoing bleeding, splenic necrosis, splenic abscess or cyst, thrombocytosis

Question 7

What is overwhelming post-splenectomy infection?

Answer 7

spleen destroys encapsulated organisms so if a patient isa splenic they cannot mount a normal response against pneumococcus, meningococcus and H influenza, so should get prophylactic penicillin