Motor vehicle accident

A 19 year old boy came to ER after being involved in a motor vehicle accident. The physical examination revealed normal Vital Signs and only abdominal pain. Laboratory analysis: WBC: 7000 and Hb: 13 mg/dL and also other blood parameters were normal Urine analysis revealed macroscophic hematuria CT scan confirmed the subcapsular hematoma of the spleen that is related to spleen laceration and left perirenal hematoma that is related to renal laceration. What will you suggest?

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Looks like grade I/II splenic injury. Need close monitoring of HD status with serial examination of abdomen and hb level. If clinically deteriorating can get a CT angio to detect possible bleeding vessel amenable for embolisation or OR. Similar approach to renal injury
Splenic laceration and perispenic. & Left peri renal collection. Maintained vitals and may need surgery of heamostasis may be splenectomy
Subcapsular haematoma of spleen requires keen observation and may rupture spleen at any time. At that time emergency spleenectomy will require . Other injuries can be treated conservative
Iv fuild + antibiotics and inj tramadol Consult surgeon for spenic damage

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