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Blunt splenic injury — RCPSC EM MCQ

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ModerateTraumaBlunt splenic injuryRCPSC EM

A 54-year-old driver in a rollover crash has abdominal pain and left lower rib tenderness. Blood pressure is 100/64 mmHg after fluids. FAST is positive in the left upper quadrant and CT shows grade IV splenic injury with contrast blush. What is the most likely diagnosis?

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Correct answer: B — Splenic laceration with active haemorrhage

High-grade splenic injury with contrast extravasation after blunt trauma is active splenic haemorrhage. Management depends on haemodynamics and local capability, with surgery or angioembolisation.

Reference: ATLS; Canadian trauma systems guidance