Splenic trauma: evaluation with CT.

Fifty-five consecutive cases of surgically proved splenic injuries were evaluated with computed tomography (CT). CT permitted correct identification of 54 splenic injuries, with one false-negative and three false-positive cases. In the single false-negative case and in two of the three false-positive cases, CT scans correctly indicated the presence of a large hemoperitoneum and other abdominal visceral lacerations and so correctly indicated the need for surgery. Of the 55 proved cases, CT demonstrated hemoperitoneum in 54 (98%), perisplenic clot in 47 (85%), splenic laceration in 39 (71%), and subcapsular hematoma in 13 (24%). Perisplenic clot can be distinguished from lysed blood in the peritoneal cavity and is a sensitive and specific sign of splenic trauma, even in the absence of visible splenic laceration. The authors conclude that CT is a highly reliable means of evaluating splenic trauma.