Journal of Trauma and Injury

Splenic Autotransplantation after Blunt Spleen Injury in Children: Hojun Lee, Byung Hee Kang, Junsik Kwon, John Cook-Jong Lee; J Trauma Inj. 2018;31(2):87-90. Published online August 31, 2018; DOI: https://doi.org/10.20408/jti.2018.31.2.87

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Non-operative management has been preferred in blunt spleen injury. Moreover children are more susceptible to post-splenectomy infection, spleen should be preserved if possible. However, splenectomy is inevitable to patients with severe splenic injury. Therefore splenic autotransplantation could be the last chance for preserving splenic function in these patients although efficacy has not proven. Here we reported four cases of children who were underwent splenic autotransplantation successfully after blunt trauma.

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Stumpfes Bauchtrauma bei Kindern und Jugendlichen: Behandlungskonzepte in der Akutphase
M. C. Schunn, J. Schäfer, F. Neunhoeffer, J. Lieber, J. Fuchs
Die Chirurgie.2023; 94(7): 651. CrossRef

Delayed Splenic Rupture Following Minor Trauma in a Patient with Underlying Liver Cirrhosis: Kyung Woon Jeung, Byung Kook Lee, Hyun Ho Ryu; J Korean Soc Traumatol. 2011;24(1):52-55.

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Abstract PDF: The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.; Summary

Spontaneous Normal Splenic Rupture: A Case Report: Sung Bae Lee, Young Il Choi; J Trauma Inj. 2014;27(4):208-210.

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Abstract PDF: Rupture of the spleen is relatively common, both immediately and in a delayed fashion following significant blunt abdominal trauma. However, atraumatic splenic rupture rarely occurs. Multiple underlying pathologies have been associated with splenic rupture without trauma, including hematological, neoplastic, inflammatory and infectious conditions. In our case, a 21-year-old male without prior medical history visited the hospital with left upper quadrant abdominal pain that had started one day earlier. He had no history of trauma. An abdominal computed tomography (CT) scan found a collection of perisplenic fluid, accompanying a splenic rupture. Due to the patient's stable vital signs and lack of clinical progression of hemorrhage, he underwent conservative treatment. The patient was discharged at day 14 without complication. Rupture of a normal spleen without a history of trauma is not often reported, and it has long been a subject of debate. Ruptures of normal spleen almost always follow some kind of trauma, such as a car accidents or a fall from significant heights. Here, we report a case of spontaneous rupture of a normal spleen in the absence of other medical pathologies or triggering factors.; Summary

Trivial Trauma and Non Pathological Delayed Splenic Rupture: A Case Report: Kwang Min Kim, Kuk Jin Kim, Hyun Chul Kim; J Trauma Inj. 2013;26(1):34-37.

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Abstract PDF: Although a majority of patients with splenic rupture present acutely, up to 15% present with a delayed rupture days to weeks following a substantial abdominal injury. The mortality for patients presenting with acute splenic rupture is approximately 1% whereas that associated with delayed rupture approaches 15%. Although many cases of delayed splenic rupture have been reported, the majority of those reports present delayed splenic rupture associated with an underlying systemic disorder such as liver or kidney disease, or another hematologic disorder. We found a delayed splenic rupture case that documented the normal spleens of young healthy soldiers after trivial abdominal trauma, and we have had successful treatment experience with delayed rupture of a normal spleen after trivial trauma. Therefore, we want to review the literature and discuss the phenomenon of delayed rupture of the spleen following trivial trauma.; Summary

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