Abstract The diagnosis of splenic rupture following trauma is often obvious, but it may present a perplexing problem. In most instances the correct diagnosis can be made from the history of the injury, the physical examination, and a few simple diagnostic studies which are well known and accepted and need not be discussed in detail here.1,2 These include radiographic evidence of splenic enlargement and/or gastric or colonic displacement on a plain film of the abdomen. However, such radiologic findings are indirect and inconsistent, and only rarely do they visualize the spleen with certainty. Although one of our patients dates back to 1954, Norell in 1957 was the first to report retrograde arteriography performed for the diagnosis of splenic trauma.3 Scattered case reports and small series of cases utilizing this approach have appeared in the literature since then.4-10 The largest group of which we are aware is that of References 1. Wang, C.C., and Robbins, L.L.: Roentgenologic Diagnosis of Ruptured Spleen , New Eng J Med 254:445-449 ( (March) ) 1956.Crossref 2. Wyman, A.C.: Traumatic Rupture of the Spleen , Amer J Roentgen 72:51-63 ( (July) ) 1954. 3. Norell, H.G.: Traumatic Rupture of the Spleen Diagnosed by Abdominal Aortography , Acta Radiol 48:449-452 ( (Dec) ) 1957.Crossref 4. Aakhus, T., and Enge, I.: Angiography in Traumatic Rupture of the Spleen , Brit J Radiol 40:855-861 ( (Nov) ) 1967.Crossref 5. Love, L., et al: Arteriography of Splenic Trauma , Radiology 91:96-102 ( (July) ) 1968.Crossref 6. Boijsen, E.; Eckman, C.A.; and Lundh, G.: " Selective Splenic Angiography ," in Welch, CE. (ed.): Advances in Surgery , Chicago: Year Book Medical Publishers, Inc., 1968, vol 3, pp 13-74. 7. Freeark, R.J.; Love, L.; and Baker, R.J.: The Role of Aortography in the Management of Blunt Abdominal Trauma , J Trauma 8:557-571 ( (July) ) 1968.Crossref 8. Baum, S., et al: The Preoperative Radiographic Demonstration of Intraabdominal Bleeding From Undetermined Sites by Percutaneous Selective Celiac and Superior Mesenteric Arteriography , Surgery 58:797-805 ( (Nov) ) 1965. 9. Pollard, J.J., and Nebesar, R.A.: Splenic Rupture Demonstrated by Selective Splenic Artery Angiogram , JAMA 187:944-945 ( (March 21) ) 1964.Crossref 10. Radiology News Briefs: Splenic Rupture Diagnosed Effectively by Arteriography , Radiology News 6:5,8 ( (July) -Aug) 1968.
Archives of Surgery – American Medical Association
Published: Oct 1, 1969