Determinants of splenectomy in splenic injuries following blunt abdominal trauma.

نویسندگان

  • A A Akinkuolie
  • O O Lawal
  • O A Arowolo
  • E A Agbakwuru
  • A R K Adesunkanmi
چکیده

INTRODUCTION The management of splenic injuries has shifted from splenectomy to splenic preservation owing to the risk of overwhelming post-splenectomy infection (OPSI). This study aimed to identify the factors that determine splenectomy in patients with isolated splenic injuries, with a view to increasing the rate of splenic preservation. PATIENTS AND METHODS Files of 55 patients managed for isolated splenic injuries from blunt abdominal trauma between 1998 and 2007 were retrospectively analysed using a pro forma. Management options were classified into nonoperative, operative salvage and splenectomy. RESULTS The majority of patients suffered splenic injury as a result of motor vehicle accident (MVA) trauma or falls. Splenectomy was undertaken in 33 (60%) patients, 12 (22%) had non-operative management, and operative salvage was achieved in 10 (18%) patients. Significant determinants of splenectomy were grade of splenic injury, hierarchy of the surgeon, and hierarchy of the assistant. DISCUSSION MVA injury and falls accounted for the vast majority of blunt abdominal trauma in this study. The rate and magnitude of energy transferred versus splenic protective mechanisms at the time of blunt abdominal trauma seems to determine the grade of splenic injury. Interest in splenic salvage surgery, availability of technology that enables splenic salvage surgery, and the experience of the surgeon and assistant appear to determine the surgical management. CONCLUSION Legislation on vehicle safety and good parental control may reduce the severity of splenic injury in blunt abdominal trauma. When surgery is indicated, salvage surgery should be considered in intermediate isolated splenic injury to reduce the incidence of OPSI.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Subtle Radiological Features of Splenic Avulsion following Abdominal Trauma

Splenic trauma in children following blunt abdominal injury is usually treated by nonoperative management (NOM). Splenectomy following abdominal trauma is rare in children. NOM is successful as in the majority of instances the injury to the spleen is contained within its capsule or a localised haematoma. Rarely, the spleen may suffer from an avulsion injury that causes severe uncontrollable ble...

متن کامل

Experience with splenic trauma in Ayub Teaching Hospital, Abbottabad.

BACKGROUND This study was carried out to estimate the prevalence, severity and mode of splenic trauma and management technique from amongst the abdominal trauma cases admitted in Ayub Teaching Hospital. METHODS The study was carried out at Surgery units of Ayub Teaching Hospital, Abbottabad, the only referral hospital for major trauma cases, from July 2001 to Dec. 2002. One hundred consecutiv...

متن کامل

Management of Blunt Trauma to the Spleen (Part 1)

Spleen is the most frequent solid organ to be injured in blunt abdominal trauma. Considering its important role in providing immunity and preventing infection by a variety of mechanisms, every attempt should be made, if possible, to salvage the traumatized spleen at any age particularly in children. After primary resuscitation, mandatory requirements for non-operative management include absence...

متن کامل

Management of Blunt Trauma to the Spleen (Part 2)

Spleen is the most frequently-injured solid organ in blunt abdominal trauma. Considering its important role in providing immunity and preventing infection by a variety of mechanisms, every attempt should be made to salvage the traumatized spleen at any age particularly in children. After primary resuscitation, mandatory requirements for non-operative management include absence of homodynamic in...

متن کامل

The Value of Urinalysis in Detection of Abdominal Organ Injuries in Children with Hematuria Following Blunt Abdominal Trauma; A Diagnostic Study

Background Currently, almost all patients with probable abdominal injury undergo urinalysis in emergency department (ED). The present survey was conducted with the aim of assessing the diagnostic values of urinalysis compare with abdominal computed tomography (CT) scan with contrast for predicting possible intra-abdominal injuries in children affected by blunt trauma. Materials and Methods: The...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie

دوره 48 1  شماره 

صفحات  -

تاریخ انتشار 2010