List Archives

Fri Nov 30 23:22:54 GMT 2007

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 &amp, 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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>   
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begin:vcard
fn:Ronald Simon, MD
n:;Ronald Simon, MD
org:Bellevue Hospital Center
adr;dom:;;550 First Avenue NBV-15S5;New York;NY;10016
title:Director of Trauma and Surgical Critical Care
tel;work:212-263-5751
version:2.1
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reimaging the spleen