Comparison of the Clinical Outcome of Nonoperative Management and Surgical Treatment of Blunt Splenic Trauma

Abstract

Objective: Nonoperative management is the preferred treatment option of blunt splenic injury in appropriate conditions. Increasing success is achieved with the help of advanced imaging techniques and angioembolization procedure. We aimed to compare clinical outcomes of Nonoperative Management and Surgical Intervention in patients with blunt splenic injury. Methods: Records of 56 patients who were treated by nonoperative management or surgical intervention in our clinic were reviewed retrospectively. Patients were evaluated in terms of age, gender, grade of injury, mortality, length of hospital stay, complications, presence of additional injuries and concomitant disease in both groups. Results: There were 29 patients (51.78%) in the surgery group and 27 patients (48.2%) in the nonoperative management group. Grade of injury was determined significantly higher in surgical treatment group (p<0.001). Additional injury was observed more in the group treated with surgery (p: 0.033). Infectious complication rate was found higher in surgically treated group (<0.001). There was no significant difference between the groups in terms of age, gender, mortality, length of hospital stay, presence of concomitant disease. Conclusion: Nonoperative management is the appropriate method in treatment of blunt splenic injury in patients who were hemodinamically stable and have no signs of peritoneal irritation. Nonoperative management is increasingly being implemented in conjunction with improvements in imaging methods. Angioembolization is a treatment that increases the success rate of nonoperative management and implementation of this method in trauma centers is an important target. Surgical intervention is inevitable in cases when the nonoperative management is inappropriate. Key words: Blunt splenic injury, Nonoperative Management, Splenectomy, Splenoraphy.