Abstract
Introduction : The nonoperative management of traumatic spleen injuries is the modality of choice in patients with blunt abdominal trauma and hemodynamic stability. However, there are still questions about the treatment indication in some groups of patients, as well as its follow-up. Aim: Update knowledge about the spleen injury. Method : Was performed review of the literature on the nonoperative management of blunt injuries of the spleen in databases: Cochrane Library, Medline and SciELO. Were evaluated articles in English and Portuguese, between 1955 and 2014, using the headings "splenic injury, nonoperative management and blunt abdominal trauma". Results : Were selected 35 articles. Most of them were recommendation grade B and C. Conclusion : The spleen traumatic injuries are frequent and its nonoperative management is a worldwide trend. The available literature does not explain all aspects on treatment. The authors developed a systematization of care based on the best available scientific evidence to better treat this condition.
Highlights
Foram incluídos os artigos em línguas portuguesa e inglesa entre 1955 e 2014, utilizando os descritores “splenic injury, nonoperative management e blunt abdominal trauma”
The spleen is the most injured body organ when there is a direct impact on the left upper quadrant, leading to intense intraperitoneal hemorrhage and shock, even though its location is well protected by costal grid[16]
In the 1980s occurred continuous surgeon efforts trying to preserve the splenic tissue in trauma victims, based on studies that demonstrated the importance of the spleen in the immune and hematopoietic system and motivating conservative operations, such as splenorraphy and segmental resection
Summary
Principais controvérsias do tratamento não operatório das lesões contusas do baço. Jorge Roberto Marcante CARLOTTO, Gaspar de Jesus LOPES-FILHO, Ramiro COLLEONI-NETO. ABSTRACT - Introduction: The nonoperative management of traumatic spleen injuries is the modality of choice in patients with blunt abdominal trauma and hemodynamic stability. Method: Was performed review of the literature on the nonoperative management of blunt injuries of the spleen in databases: Cochrane Library, Medline and SciELO. Were evaluated articles in English and Portuguese, between 1955 and 2014, using the headings “splenic injury, nonoperative management and blunt abdominal trauma”. RESUMO - Introdução: O tratamento não operatório das lesões traumáticas do baço é a modalidade de escolha nos pacientes com trauma abdominal contuso e estabilidade hemodinâmica. Método: Realizou-se revisão da literatura sobre o tratamento não operatório das lesões contusas do baço nas bases de dados: Cochrane, Medline e SciELO. Foram incluídos os artigos em línguas portuguesa e inglesa entre 1955 e 2014, utilizando os descritores “splenic injury, nonoperative management e blunt abdominal trauma”. Elaborouse sistematização de atendimento baseada nas melhores evidências científicas disponíveis para facilitar seu manejo
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