spleen – Surgery Superspeciality MCQS

Grades of Splenic Injury – Image based Question

2024-09-132023-07-10 by admin

Q) 45 year old male with road side accident and fracture of 3 ribs on left side. CT scan of the abdomen is shown below. Out of the five grades of splenic injury What is the grade in him ?

Splenic Injury grades

a) Grade II

b) Grade III

c) Grade IV

d) Grade V

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Ans b Grade III

Grade 1

Subcapsular haematoma <10% of surface area
Parenchymal laceration <1 cm depth Capsular tear

Grade 2

Subcapsular haematoma 10–50% of surface area; Intraparenchymal haematoma <5 cm
Parenchymal laceration 1–3 cm

Grade 3

Subcapsular haematoma >50% surface area; ruptured subcapsular or intraparenchymal haematoma ≥5 cm Parenchymal laceration >3 cm depth

Grade 4

Any injury in the presence of a splenic vascular
injury or active bleeding confned within the splenic
capsule
Parenchymal laceration involving segmental or hilar
vessels producing >25% devascularisation

Grade 5

Any injury in the presence of splenic vascular injurya
with active bleeding extending beyond the spleen
into the peritoneum – shattered spleen

Vascular injury is defined as a pseudoaneurysm or arteriovenous fistula and appears as a focal collection of vascular contrast that decreases in attenuation with delayed imaging.

Active bleeding from a vascular injury presents as vascular contrast, focal or diffuse, that
increases in size or attenuation in the delayed phase

Bailey 1224

Splenic cyst

2022-03-01 by admin

Q) A 35 year old asymptomatic male undergoes a routine USG which reveals a 3 cm Splenic cyst. There is a prior history of trauma 2 months back. CT Shows smooth, unilocular, thick walled lesion. What should be further management

a) Conservative

b) Partial Splenectomy

c) Total Splenectomy

d) Percutaneous Aspiration