PEDIATRICS Vol. 78 No. 4 October 1986, pp. 576-580
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Splenic Trauma in the Pediatric Patient: The Integrated Roles of Ultrasound and Computed Tomography

Dorit D. Adler MD1, Caroline E. Blane MD1, Arnold G. Coran MD1, and Terry M. Silver MD1

1 From the Departments of Radiology and Surgery, Section of Pediatric Surgery, University of Michigan Medical School, Ann Arbor

Seven children who sustained splenic trauma were scanned by ultrasound and computed tomography (CT) or ultrasound and nuclear liver/spleen scan. All patients were managed conservatively and did not need abdominal surgery. On the initial sonogram, the majority of children had multiple areas of both increased and decreased echogenicity. Hematomas were followed to resolution in five of seven children and were usually multiple and hypoechoic prior to complete disappearance. On contrast-enhanced CT scans, areas of splenic hemorrhage appeared as low attenuation. Our small patient population demonstrates that, following an initial CT scan, sonography is helpful for sequential splenic imaging to show when the appearance of the spleen returns to normal. When correlated with the clinical information, such data are helpful to the clinician in determining when a child who has sustained splenic trauma may resume normal activity.

Key Words: spleen • injury • ultrasound • computed tomography

Submitted on November 14, 1985
Accepted on January 22, 1986