reimaging the spleen

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Simple - we all now have our own unreported series of a few hundred speens that we have followed with innumerable scans.  We could probably collect them and show that the time to completely heal varies but only slightly from a grade III to IV, with most V's (and I hesitate to even say that anymore, with the more liberal use of CT and angio) already in the bucket before the pt hits the scanner for his unnecessary followup head CT for the minimal SAH with an improving neuro exam!

Now, exactly what is the timeframe I was referring to for the Grade II'and IV's?  Well, from my experience (when I did scan 'em all) complete normalization og the scans by 3 months was a pretty good bet.

Ron (the other one!)

>>> "Ronald Simon" <Traumamd at nyc.rr.com> 11/30/07 6:22 PM >>>
I have always re imaged the spleen to prove healing. Once healed, nl 
activity can be pursued. I always believed the injured spleen was more 
susceptible to injury. Now with CT and angio, i don't worry about 
delayed ruptures. I think these were just missed pseudoaneurysms that we 
now catch. If one does not rescan, how to you advise a patient with a 
grade 3 or 4 liver injury as far as returning to nl activities?
ron simon

Robert F. Smith wrote:
> For those who advocate rescanning, what is it that they need to see that the
> presence of would make them confident that it's OK to take a helmet in the
> gut and the absence would let them know it was unsafe?
>
> Rob Smith
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
> On Behalf Of caesar ursic
> Sent: Friday, November 30, 2007 12:43 PM
> To: Trauma &, Critical Care mailing list
> Subject: Re: BIG NEWS - CT Causes Leukemia ?
>
> Ron, I did get your original post and responded (indirectly) above.  I think
> I'm going to have to go back and re-read all the studies to convince myself
> that the preponderance of evidence does (or does not?) truly support
> re-scanning asymptomatic spleens after discharge.  I'll be surprised if it
> is the latter.
>
> My own (and I suspect others') motivation in obtaining these scans is to
> diagnose the occasional 'silent' post-traumatic intrasplenic pseudoaneurysm
> that can suddenly rupture and bleed, as well as to 'document' early and
> ongoing healing and resolution of hematomas, etc.  I suppose that ultrasound
> can be used for this, but that its sensitivity is way below that of CT's. I
> do remember reading posts by at least one other regular contributor to this
> list ("Don' Think You Are, Know You Are -Morpheus") who routinely performs
> surveillance angiography on the injured spleen for this very reason.
>
> Karim Brohi, what do you do at the Royal London Hospital?
>
> CM Ursic
> Santa Fe, NM, USA
>
>
>
> On 11/30/07, Ronald Gross <Rgross at harthosp.org> wrote:
>   
>> Ceasar,
>>
>> I am puzzled as to why my posts haven't been getting through.  What I
>> did say was that I do not scan and I do not allow the kids to return to
>> contact sports until the FOLLOWING season.  I have not as yet heard from
>> any others on the list as to their opinions/practices.
>>
>> Ron
>>
>>
>>     
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