Resciniti et al developed a computed tomographic (CT) scoring system for evaluating patients with splenic trauma. This can help predict which patients can be managed conservatively and which may need operative intervention.
Regions observed on CT scan:
(1) splenic parenchyma
(2) splenic capsule
(3) abdominal fluid
(4) pelvic fluid
|
Region |
Finding |
Points |
|
splenic parenchyma |
intact |
0 |
|
|
laceration (linear defects) |
1 |
|
|
fracture (thick, irregular defects) |
2 |
|
|
shattered |
3 |
|
splenic capsule |
intact |
0 |
|
|
possible perisplenic fluid |
0.5 |
|
|
perisplenic fluid present |
1 |
|
abdominal fluid |
none |
0 |
|
|
possible intra-abdominal fluid |
0.5 |
|
|
any intra-abdominal intraperitoneal fluid (excluding perisplenic fluid) |
1 |
|
pelvic fluid |
none |
0 |
|
|
possible intraperitoneal pelvic fluid |
0.5 |
|
|
any intraperitoneal pelvic fluid |
1 |
after Table 1, page 829
CT score =
= SUM(points for the 4 regions)
Interpretation:
• minimum score: 0
• maximum score: 6
• Adults with a score < 2.5 did not require delayed operative intervention and can be managed conservatively.
• Patients with scores >= 2.5 can be managed conservatively, but the need for operative intervention increases as the score increases.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Gastroenterology
