Abstract
This is retrospective study of splenic trauma managed at Al-Zahrawi Teaching Hospital and Saddam General Hospital in Mosul Province. The data of 108 patients during the study between the first of January 1993 and the 13 th of June 1997; have been analyzed. Males were three times affected more than females. The mean age was 24 years, and the highest incidence was encountered in those below the age of 10 years (39.8%). Blunt splenic trauma was much more common than penetrating injury (73% vs 27%). Road traffic accidents (41.7%) and fall from height (25%) were the most common causes. Splenic injuries were graded in severity from one to five. Twelve percent were grade I injuries, 13% grade II, 14% grade III, 16% grade IV, 27% grade V, and 19% of unknown grade. Associated injuries were frequent, occurred in 63% of patients. The majority of the patients (94.4%) were treated by splenectomy whereas only (5.6%) had splenorraphy performed. Delayed rupture of the spleen was present in two patients (1.9%) who required splenectomy more than 48 hours post-injury. Postoperative complications were common, occurred in 47 patients (34.5%). Pulmonary infection had the higher incidence and occurred in (20.4%) of the patients. Wound infection was present in 8 patients (7.4%) and peritonitis in 7 patients (6.4%). However, complications were more frequent in those severely injured with multiple associated injuries. The overall mortality was (25%). Sixteen patients (15%) with blunt splenic injury and 11 patients with penetrating injury died. Death generally occurred in those with severe associated injuries like head injuries. The two most common causes of death were exsanguination (8.3%) and septicemia.
Highlights
The spleen remains the most common injured organ in patients who sustained blunt abdominal trauma
Splenectomy was considered the safest approach to the injured spleen, extirpation of the spleen eliminated the risk of post-operative hemorrhage, and was believed to be without detriment to the patient[3,4]
The understanding of the important immunologic functions of this organ and that asplenic patients are at an increased risk from a number of postoperative complications such as pulmonary and wound infections, thromboembolic sequelae, overwhelming post-splenectomy sepsis, and possible fatal coronory artery disease have led to unprecedented efforts to preserve this organ in instances of injury, and techniques of splenic preservation have been introduced to avoid these potential problems[5,6]
Summary
The spleen remains the most common injured organ in patients who sustained blunt abdominal trauma. Such injuries to the spleen represent approximately one quarter of all blunt and penetrating thoraco-abdominal injuries. The understanding of the important immunologic functions of this organ and that asplenic patients are at an increased risk from a number of postoperative complications such as pulmonary and wound infections, thromboembolic sequelae, overwhelming post-splenectomy sepsis, and possible fatal coronory artery disease have led to unprecedented efforts to preserve this organ in instances of injury, and techniques of splenic preservation have been introduced to avoid these potential problems[5,6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
