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.
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Authors | I M Bain, R M Kirby |
Journal | Injury
(Injury)
Vol. 29
Issue 3
Pg. 177-82
(Apr 1998)
ISSN: 0020-1383 [Print] Netherlands |
PMID | 9709417
(Publication Type: Journal Article)
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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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