Nonoperative management of splenic injury: are follow-up computed tomographic scans of any value?
Thaemert, B.C.; Cogbill, T.H.; Lambert, P.J.
Journal of Trauma 43(5): 748-751
1997
ISSN/ISBN: 0022-5282 PMID: 9390484 Document Number: 478524
Objective: To determine the value of follow-up abdominal computed tomography in patients with splenic trauma managed nonoperatively. Design: Retrospective chart review. Materials and Methods: A total of 108 consecutive patients with splenic injuries treated at a single institution from 1990 to 1996 were studied. All admission and follow-up computed tomographic (CT) scans were reviewed by the authors. Results: Initial management was surgical in 35 patients (32%) and intentionally nonoperative in 73 patients (68%). Nonoperative management was successful in 45 of 49 adults (92%) and 21 of 24 children (88%). Sixty-two follow-up abdominal CT scans were obtained in 49 patients. Information that affected management was evident on only one follow-up CT scan performed in the absence of clinical indications. Potential savings in hospital and physician charges for routine follow-up CT scans in this study were dollar sign54,302.00. Conclusions: Follow-up abdominal CT scans are not routinely necessary in patients with splenic injuries managed nonoperatively.