Unstable
FAST to search for free fluid (vs. DPL if unavailable)
Positive: Exploratory laparotomy
Negative: CT scan
Stable
CT scan
Exploratory laparotomy, angiographic embolization, conservative management as indicated
FAST to search for free fluid (vs. DPL if unavailable)
Positive: Exploratory laparotomy
Negative: CT scan
Positive: Exploratory laparotomy
Negative: CT scan
CT scan
Exploratory laparotomy, angiographic embolization, conservative management as indicated
Exploratory laparotomy, angiographic embolization, conservative management as indicated
Subcapsular, <10% of surface area
Capsular tear <1 cm in depth into the parenchyma
Subcapsular, 10-50% of surface area
Capsular tear, 1 to 3 cm in depth, but not involving a trabecular vessel
Subcapsular, >50% of surface area OR expanding,
Ruptured subcapsular or parenchymal hematoma
OR, intraparenchymal hematoma >5 cm or expanding
Capsular tear, 3 to 10 cm in depth or involving a trabecular vessel.
Subcapsular or central hematoma > 10cm
Involving segmental or hilar vessels with major devascularization (i.e. >25% of spleen)
Shattered spleen
Hilar vascular injury which devascularizes spleen.
Splenic trauma
Diaphragmatic trauma
Splenic infarction
Liver trauma
Abdominal trauma
Intestinal ischemia
Pelvic fractures
Acetabular pelvic fractures