Diagnosis: Splenic rupture with intraperitoneal hemorrhage

Modality: CT

Findings on Imaging:

  • Imaging studies such as ultrasound, CT, or MRI may show a splenic rupture, which is the result of a traumatic injury to the spleen.
  • On ultrasound, a splenic rupture may show as a heterogeneous and irregularly shaped splenic parenchyma with or without surrounding fluid.
  • On CT, the rupture may be visualized as a laceration or a large area of low attenuation within the spleen.
  • Other signs of a splenic rupture may include free fluid in the abdomen or pelvis, and hemoperitoneum.

Next Steps in Management:

  • Management of a splenic rupture depends on the extent and severity of the injury.
  • Treatment options may include observation, blood transfusion, surgical intervention such as splenorrhaphy or splenectomy, and supportive care.
  • Regular imaging follow-up is recommended to monitor for healing and to detect any complications such as abscess or infection.

Key Take Away Points:

  • Splenic rupture is a potentially life-threatening condition that can result from a traumatic injury to the spleen.
  • Imaging studies such as ultrasound, CT, or MRI can help diagnose a splenic rupture by showing the extent of the injury.
  • Treatment of a splenic rupture may include observation, blood transfusion, surgical intervention, and supportive care.
  • Regular imaging follow-up is recommended to monitor for healing and to detect any complications such as abscess or infection.

Credit: Case submitted by radiologist Dr. Ellie Goulding M.D. to radRounds Radiology Network