The Role of Measurement of Intraabdominal Bleeding by Ultrasonography in Splenic Injury

Mitsuru Kikuchi, Shigeatsu Endo*, Kunihiro Hirosawa, Takeshi Kasai

Trauma and Emergency Center, Kameda General Hospital
*Critical Care and Emergency Center, Iwate Medical University

The hourly and total volumes of bleeding in 36 patients with traumatic splenic injuries were determined by ultrasonography (US). Patients were classified into either group a (10 patients who managed conservatively), group B (9 patients who had undergone splenorraphy or partial splenectomy) and group C (17 patients who had undergone total splenectomy). The volume of bleeding estimated by US was compared to the bleeding by US was compared to the bleeding volume determined at operation, and the hourly volume loss was calculated. The mean estimated amount of bleeding was 727.3 ml in group A, 1077.8 ml in group B, and 1585.3 ml in group C, with a significant difference between groups A and C (p<0.05). The amount of blood loss estimated by US was compared with the blood loss measured at operation in the 26 patients who had undergone surgery. There was a good correlation (R=0.748, p<0.01) between the estimated and measured amounts of bleeding. The mean amount of bleeding was 12.7 ml/h for group a, 256.2 ml/h for group B and 258.5 ml/h for group C. The difference between grpoups A and C was significant (p<0.05). In conclusion, the estimated amount of bleeding in the abdominal cavity caused by injury of the spleen can be used as a criterion in the determination of surgery. Surgical treatments should be considered if the total amount of bleeding is estimated to be more than 1000 ml or if the rate of bleeding is higher than 150-200 ml/h.

Key words
splenic injury, intraabdominal bleeding, ultrasonography

Reprint requests
Mitsuru Kikuchi Trauma and Emergency Center, Kameda General Hospital
929 Higashi-chou, Kamogawa, 296 JAPAN

Accepted
June 12, 1996

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