Most commonly ruptured organ in blunt trauma to abdomen is: March 20

Ans. D: Spleen Splenic rupture should be considered in any case of blunt abdominal trauma, paicularly when the injury occurs to the left upper quadrant of the abdomen Although protected under the bony ribcage, the spleen remains the most commonly affected organ in blunt injury to the abdomen in all age groups. These injuries are common in both rural and urban environments and result from motor vehicle crashes, domestic violence, spoing events, and accidents involving bicycle handlebars. The clinical presentation of splenic injury is highly variable. Most patients with minor focal injury to the spleen complain of left upper quadrant abdominal tenderness. Left shoulder tenderness may also be present as a result of subdiaphragmatic nerve root irritation with referred pain. With free intraperitoneal blood, diffuse abdominal pain, peritoneal irritation, and rebound tenderness are more likely. If the intra-abdominal bleeding exceeds 5-10% of blood volume, clinical signs of early shock may manifest. Hypotension in a patient with a suspected splenic injury, especially if young and previously healthy, is a grave sign and a surgical emergency.