Subcapsular splenic hematoma
Imaging
findings of splenic emergencies: a pictorial review. Splenic subcapsular hematoma. Coronal contrast-enhanced CT image of a 18-year-old man demonstrates parenchymal, subcapsular splenic hematoma (arrow) and accompanying retroperitoneal hematoma (arrowheads). Devascularised left kidney is also noted
Subcapsular splenic hematomas are a type of splenic hematoma that occurs beneath the splenic capsule.
Pathology
They can occur in both traumatic and non-traumatic situations.
Associations
- abdominal: splenic trauma , a subcapsular hematoma is part of imaging criteria for grades I-III of the AAST splenic injury grading system
- infectious mononucleosis
- pancreatitis
- cocaine use
Radiographic features
CT
Imaging in the portal venous phase is best for detection. CT typically shows a crescentic/lenticular perisplenic collection where attenuation values depend on the age of the hematoma. The hematoma may flatten or indent
the lateral margin of the spleen .
- acute: hyperattenuating to isoattenuating , then called subcapsular hemorrhage
- subacute: iso attenuating, within 1-2 days of bleeding, CT attenuation values of splenic hematomas may be equal to or greater than that of the splenic
parenchyma - established/chronic: hypoattenuating
