Size of Splenic Subcapsular Hematoma Is Associated With Varying Outcomes of Nonoperative Management

Navpreet K Dhillon; Melike N Harfouche; Joseph J DuBose; Rosemary A Kozar; Thomas M Scalea

doi:10.1177/00031348241241734

Size of Splenic Subcapsular Hematoma Is Associated With Varying Outcomes of Nonoperative Management

Am Surg. 2024 Mar 29:31348241241734. doi: 10.1177/00031348241241734. Online ahead of print.

Authors

Navpreet K Dhillon¹, Melike N Harfouche¹, Joseph J DuBose², Rosemary A Kozar¹, Thomas M Scalea¹

Affiliations

¹ Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD, USA.
² Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas, Austin, TX, USA.

PMID: 38553793
DOI: 10.1177/00031348241241734

Abstract

The presence of a splenic subcapsular hematoma (SCH) has been associated with higher rates of failure of nonoperative management (FNOM) in patients with blunt splenic injury (BSI), with rates up to 80%. We hypothesized that contemporary rates are lower. A retrospective review was conducted of patients admitted with BSI to a level I trauma center (2016-2021). Patients with SCH who had FNOM were compared to those who did not. There were 661 BSI patients, of which 102 (15.4%) had SCH. Among the SCH patients, 8 (7.8%) had FNOM. Failure of nonoperative management was higher in patients who had a SCH measuring 15 mm or greater. To the best of our knowledge, this is the largest study to date examining the relationship between SCH and FNOM. The presence of a SCH alone is not associated with a high risk for FNOM contrary to previous literature. However, SCH thickness was larger in those who failed.

Keywords: nonoperative management; spleen; splenic trauma; subcapsular hematoma; trauma.