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19.02.2018

Splenic contraction: a new member of the hypovolemic shock complex

verfasst von: Michael S. Enslow, Stephen R. Preece, Benjamin Wildman-Tobriner, Ryan A. Enslow, Maciej Mazurowski, Rendon C. Nelson

Erschienen in: Abdominal Radiology | Ausgabe 9/2018

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Abstract

Objective

The objective of the article is to assess changes in splenic volume in the setting of hypovolemic shock; splenic enhancement in hypovolemic shock is also assessed.

Materials/methods

71 consecutive adult patients with the hypovolemic shock complex on computed tomography (CT) were identified. Spleen volume and enhancement were compared to a baseline CT scan (without shock) or to height- and sex-corrected normal values and a control population when a comparison CT was unavailable.

Results

Splenic volume was significantly lower in the setting of shock. Average splenic volume in adult patients with shock was 107 ± 63 cm³ compared to 220 ± 164 cm³ in the control population (P < 0.001). All shock patients with a comparison CT (n = 35) had decreased splenic volume in the setting of shock. The area under the receiver operating characteristic (ROC) curve for spleen volume predicting shock was 0.83. Splenic enhancement was also significantly lower in the setting of shock. Mean splenic attenuation value in our shock population was 105 ± 34 HU compared to 134 ± 25 HU in the control population (P < 0.001). Decreased splenic enhancement was present in 25 of 71 shock patients and in none of the control patients (P < 0.001).

Conclusion

Decreased splenic volume is a ubiquitous and reliable sign of hypovolemic shock and should be considered a member of the hypovolemic shock complex. It is of particular utility when a prior study is available. Splenic hypoenhancement has high specificity and a high positive predictive value for hypovolemic shock in the correct patient population.

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Titel: Splenic contraction: a new member of the hypovolemic shock complex
verfasst von: Michael S. Enslow
Stephen R. Preece
Benjamin Wildman-Tobriner
Ryan A. Enslow
Maciej Mazurowski
Rendon C. Nelson
Publikationsdatum: 19.02.2018
Verlag: Springer US
Erschienen in: Abdominal Radiology / Ausgabe 9/2018
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-018-1478-3

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Splenic contraction: a new member of the hypovolemic shock complex

Abstract

Objective

Materials/methods

Results

Conclusion

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Abstract

Objective

Materials/methods

Results

Conclusion

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