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Spleen: trauma
Introduction
- Cause: blunt trauma (eg HBC/RTA, kicks) or occasionally penetrating injuries to the abdomen.
- Signs: can be sudden in onset (hemorrhagic shock) or more insidious.
- The most serious consequence is hemorrhage, which may be life-threatening.
- Diagnosis: may be problematical. A high incidence of suspicion of this condition should be maintained in traumatized animals.
- Treatment: fluid therapy, oxygen administration, blood transfusion, partial or total splenectomy.
- Prognosis: fair provided initial stabilization is successful and there are no other internal injuries.
Presenting signs
- History of trauma or clinical suspicion of this in cats returned home or found injured.
- Pale mucous membranes and slow capillary refill time.
- Abdominal distension and fluid wave.
- Rapid pulse; poor pulse volume.
- Tachypnea.
- Bruised or damaged skin on flanks.
- Puncture or entry wounds on flanks.
Acute presentation
- Massive hemoperitoneum may result in a collapsed cat in hemorrhagic shock Shock.
Special risks
- Anesthesia General anesthesia: overview is a special risk in cats in hemorrhagic shock. These animals must be stabilized prior to the administration of any depressive drugs.
Pathogenesis
Etiology
- Road traffic accidents or other blunt trauma (eg kicks) are the most common causes.
- Many cats are targets of air guns. Occasionally these pellets may lacerate the spleen.
Pathophysiology
- Rupture of the splenic parenchyma or avulsion of splenic blood vessels results in hemorrhage and hemoperitoneum.
Timecourse
- Rapid if massive bleeding into the abdomen; progressive if there is a lesser degree of injury which nevertheless continues to bleed.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Vinayak A, Krahwinkel D J (2004) Managing blunt trauma-induced hemoperitoneum in dogs and cats. Comp Cont Educ Pract Vet 26 (4), 276 VetMedResource.
- Spangler W L & Culbertson M R (1992) Prevalence and type of splenic diseases in cats - 455 cases (1985-1991). JAVMA 201 (5), 773-776 PubMed.