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10 year experience of splenic injury: an increasing place for conservative management after blunt trauma.

Abstract
It has been suggested that over 30 per cent of splenic injuries are suitable for conservative management by non-operative treatment and splenorrhaphy; splenic conservation avoids the risk of overwhelming post-splenectomy infection. In this study, injuries of the spleen have been retrospectively analysed for a 10 year period. In the first 5 years the spleen was conserved in only 6/45 (15 per cent) of patients with blunt injury (three non-operative, three splenorrhaphy). In the second 5 years of the study, the spleen was conserved in significantly more patients with blunt trauma, 25 of 61 (41 per cent). This change has been a result of increased non-operative management which has been successful in the majority of cases (20/22). This has been associated with the increased use of abdominal ultrasound. The rate of splenorrhaphy has not changed significantly, five patients compared with three in the previous 5 years. Non-operative management may be increasingly appropriate as less severe splenic injuries are being detected with an increased use of ultrasound. Splenic injury is not a mandatory indication for laparotomy; non-operative management of splenic injuries should be considered in selected patients who are haemodynamically stable and can be closely monitored.
AuthorsI M Bain, R M Kirby
JournalInjury (Injury) Vol. 29 Issue 3 Pg. 177-82 (Apr 1998) ISSN: 0020-1383 [Print] Netherlands
PMID9709417 (Publication Type: Journal Article)
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spleen (injuries)
  • Splenectomy
  • Wounds, Gunshot (surgery, therapy)
  • Wounds, Nonpenetrating (surgery, therapy)
  • Wounds, Stab (surgery, therapy)

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