Appropriate Management of Splenic Trauma

Abstract

Introduction: Inappropriate management of splenictrauma is related to high rates of morbidity and mortality, and an effective understanding of its mechanisms is vital. Closed abdominal or thoracoabdominal trauma, such as localized contusions from various incidents, is typically the cause of splenic injuries. Splenic trauma must be promptly evaluated in the context of urgency, and a surgical approach must be performed according to the degree of injury. Methods: This is a retrospective, quantitative, and cross-sectional analysis of the medical records of operated-on patients. Results: The medical records of 50 patients were analyzed, scored, and selected based on the following variables: mechanism of trauma, clinical signs of splenic injury, splenectomy as an emergency approach, degree of injury, postoperative period, complications, sequelae, and length of stay after surgery, as well as the need for intensive care unitadmission and mortality. Data from 50 medical records of patients undergoing urgent splenectomy allowed researchers to draw the conclusion that 48% of patients had experienced splenic trauma as a result of auto accidents, and 38% of patients had Kehr's sign. Additionally, it was determined that grade III–V injuries were the most common in 70% of the cases submitted for urgent splenectomy after an anatomopathological investigation. Further, localized abscesses, the most common type of complications, were present in 50% of the patients. The average length of stay was 8 days, and 38% of the patients needed an intensive care unit. Finally, it was possible to conclude that 10% died. In terms of care, a profile has been established in which a direct and effective approach is required because, when compared with current literature, the number of patients with complications is very low when compared to patients approached conservatively, who present a degree of sequelae of 70% depending on the degree of injury. Conclusion: As a result, the demand for more effective policies that aim to reduce morbidity and mortality is reinforced. This is critical given the high frequency of instances.