[Spleen-preserving surgery after blunt abdominal trauma with splenic hilum involvement].

Abstract

BACKGROUND:

Splenic involvement secondary to blunt abdominal trauma is often treated by performing a splenectomy. The severity of the post-splenectomy syndrome is currently well known (blood loss, sepsis), so there is an increasing tendency to preserve the spleen. The case is presented of splenic preservation after blunt abdominal trauma with hilum involvement, emphasising the role of Floseal as a haemostatic agent, as well as the use of resorbable meshes to preserve the spleen.

CLINICAL CASE:

A 22-year-old woman presenting with a grade IV splenic lesion secondary to a blunt abdominal trauma after a traffic accident. Partial splenic resection was performed and bleeding was controlled with Floseal and use of a reinforcing polyglycolic acid mesh. No postoperative complications occurred, being discharged on day 5. The long-term follow-up has been uneventful.

CONCLUSION:

The use of haemostatic agents such as thrombin and the gelatine gel (FloSeal) and the use of polyglycolic acid meshes enable spleen-preserving surgery, making it a feasible and reproducible procedure and an alternative to classical splenectomy.

• Authors: José Aurelio Navas-Cuéllar, Jesús Cañete-Gómez, Francisco López-Bernal, Carla García-Rivera, Felipe Pareja-Ciuró, Javier Padillo-Ruiz
• Journal: Cirugia y cirujanos (Cir Cir) 2015 Nov-Dec Vol. 83 Issue 6 Pg. 516-21 ISSN: 2444-054X [Electronic] Mexico
• Vernacular Title: Cirugía preservadora de órgano tras traumatismo esplénico cerrado con implicación hiliar.
• PMID: 26141106 (Publication Type: Case Reports, English Abstract, Journal Article)
• Copyright: Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Chemical References

• FloSeal Matrix
• Polyglycolic Acid

Topics

• Abdominal Injuries (surgery)
• Accidents, Traffic
• Electrocoagulation
• Emergencies
• Female
• Gelatin Sponge, Absorbable
• Hemorrhage (etiology, surgery)
• Hemostasis, Surgical
• Hemostatic Techniques
• Humans
• Lacerations (surgery)
• Organ Sparing Treatments (methods)
• Polyglycolic Acid
• Spleen (injuries, surgery)
• Splenectomy (methods)
• Surgical Mesh
• Wounds, Nonpenetrating (surgery)
• Young Adult