Which of the following is the most common organ injured in blunt abdominal trauma?

Explanation

## Organ Injury Frequency in Blunt Abdominal Trauma **Key Point:** The **spleen** is the most commonly injured solid organ in blunt abdominal trauma, accounting for approximately 25–40% of all solid organ injuries in most modern trauma series. ### Why the Spleen? - Highly vascular and fragile parenchyma with low tensile strength - Superficial location in the left upper quadrant with minimal bony protection - Susceptible to direct impact (e.g., left-sided rib fractures, steering wheel, handlebar injuries) - Deceleration forces cause tearing of splenic attachments and capsular lacerations ### Comparative Frequency of Organ Injuries in Blunt Trauma | Organ | Frequency (%) | Injury Pattern | | --- | --- | --- | | **Spleen** | **25–40** | Laceration, rupture, subcapsular haematoma | | Liver | 20–35 | Laceration, contusion, haematoma | | Kidney | 10–15 | Contusion, laceration | | Small bowel | 5–10 | Perforation | | Pancreas | 3–5 | Laceration, crush injury | ### Clarification on Liver vs. Spleen - In **penetrating trauma**, the liver is the most commonly injured organ due to its large surface area. - In **blunt abdominal trauma**, the **spleen** is consistently cited as the most commonly injured solid organ in standard surgical references (Bailey & Love, Schwartz's Principles of Surgery, ATLS 10e). - The spleen's fragility and relatively unprotected position make it uniquely vulnerable to blunt force. **High-Yield:** Splenic injuries are managed non-operatively (NOM) in haemodynamically stable patients; splenectomy is reserved for haemodynamic instability or failed NOM. Post-splenectomy patients require vaccination against encapsulated organisms (*S. pneumoniae*, *H. influenzae*, *N. meningitidis*). **Clinical Pearl:** Pancreatic injuries are the rarest solid organ injury in blunt trauma but carry the highest morbidity and mortality due to delayed diagnosis and associated ductal injury (diagnosed by MRCP or ERCP). [cite: Bailey & Love's Short Practice of Surgery, 27e; Schwartz's Principles of Surgery, 11e; ATLS 10e]