Radionuclide imaging in the nonsurgical treatment of liver and spleen trauma

Twenty-nine patients had splenic or hepatic defects on^99mTc sulfur colloid scintigraphy performed after abdominal trauma. All were treated conservatively. One additional patient had a scan after a laceration was oversewn. Followup scans in 24 patients 1 to 13 months later showed resolution that was complete in nine, partial in 12, and unchanged in three. No defects enlarged. All but two patients were completely asymptomatic; two children with occasional unexplained upper abdominal pain had progressively resolving splenic defects. We conclude that surgery may not always be necessary for liver-spleen injury, that radionuclide imaging is useful in evaluation of healing as well as in initial diagnosis, and that the risk of 'delayed’ rupture is much smaller than heretofore feared.