Splenorrhaphy: omental pouch.

This work studies the efficacy of an autogenous viable omental pouch as a means of splenorrhaphy for saving the traumatised spleen. One sheep and 9 goat spleens were mobilised and their vascular pedicles clamped. All spleens were subjected to AAST grade IV trauma. The injured spleens were put into omental pouches and manual pressure was applied for 10 minutes after removal of the vascular clamp. Bleeding was controlled in 8 animals which became fully active 12-36 hours postoperatively. Two animals died, one due to aspiration of gastric contents during surgery and the other due to bleeding 24 hours postoperatively. All remaining spleens were harvested after 6 weeks. They were surrounded by a fibrous capsule and the previously inflicted injuries were easily identifiable. Viable omental pouch based on left epiploic vascular pedicle offers itself as a good autogenous alternative other methods used for saving the injured spleen. This method has been used in two humans so far.