Ultrasound image of Splenic trauma

Splenic laceration may be particularly difficult to detect on ultrasound, particularly in the immediate post-trauma phase. The presence of free fluid in the abdomen of a trauma victim should alert the sonographer to the strong possibility of organ injury. The laceration may appear as a subtle, hyperechoic line within the spleen immediately after the injury. A frank area of haemorrhage, easily identifiable on ultrasound, may not develop until later.
CT is normally performed following the identification of free fluid on ultrasound in order to assess the extent of organ injury. Intrasplenic pseudoaneurysm is a recognized, but rare complication of splenic trauma, which can be demonstrated on colour Doppler.
In rare cases, spontaneous splenic rupture may be encountered, most usually associated with massive splenomegaly of the sort seen in infectious mononucleosis.

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