Decreased Splenic Enhan Splenic enhancement is typica!ly greater than in However, in the hypovolemic state, the spleen may show reduced enhancement without any evidence of injury to the vessel or parenchyma as a result of hypoperfusion of the organ(Figure 6). The frequency of decreased splenic enhancement severe hypovolemia ranges from l 19-29.6% 18,13,161. A decrease in splenic enhancement of Go HU in children or 20 HU in adults when compared witin une liver is considered abnormal[16,171. Kanki et al i oi demonstrated that extreme splenic hypoperfusion is associated with poorer prognosis and may usetui in predicting patient outcome. In their retrospective review of 33 patients with hypovolemic shock, the patients who eventually died of their injuries showed significantly lower splenic enhancement at initial imaging than uhe survival group. Splenic hypoperfusion may also be caused by trau- matic injury to the splenic vascular pedicle, and differenti ation of these 2 causes of splenic hypoperiusion is an important consideration in patient management because the Figure Calibre latter may require emergent splenic intervention 171. Thc below ylcscucu ui perispiellic or illiraparenciymai nematomas or enhancem active extravasation is suggestive of splenic vascular injury, cava