Management of Splenic Injuries Following Blunt Abdominal Trauma: Our Experience
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : A. Matsou, K. Valsamidis, G. Vrakas, D. Zerva, K. Hatzimisios, K. Saliangas
- چاپ و سال / کشور: 2011
Description
Aim - Background: Trends in the management of blunt splenic trauma have shifted over the years from splenectomy to splenic preservation. The Aim of the manuscript is to identify the factors that influence the choice of treatment for spleen trauma. Material-Method: We conducted a retrospective review of the medical records of patients admitted with blunt splenic injury to our regional hospital over a two-year period (2008-2010). Haemodynamic status upon admission, computed tomography grade of splenic tear, presence and severity of associated injuries have been taken into account to determine the treatment of choice. Therapeutic options were classified into non-operative, operative salvage and splenectomy. Results: Fourteen patients (9 males 64.2%) were admitted with blunt splenic trauma. The most common mechanism of injury was motor vehicle accident (MVA) (64.2%). Splenectomy was undertaken in 7 (50%) patients, in 2 (14.3%) operative salvage was achieved and 5 (35.7%) were selected for nonoperative- management (NOM). Grade of splenic injury, concomitant injuries and haemodynamic stability were identified as significant determinants of the form of treatment provided. Conclusions: NOM can be successfully performed for haemodynamically stable patients with blunt splenic trauma. When surgery is indicated, intraoperative salvage should be considered to reduce the incidence of OPSI. Further research should be made into whether splenectomy is overused.
Hellenic Journal of Surgery 2011; 83: 1 Received 27/12/2010 Accepted 15/01/2010
