Splenic injury: a clinical study and management in a tertiary care hospital

Abstract

Background: Splenic injury is one of the most commonly injured solid organs in blunt abdominal injury and it is often associated with significant mortality and morbidity. With the advancement in diagnosis and treatment, the management strategy has gradually changed to a non-invasive management. This study is aimed to study the Clinical presentation in a patient with splenic trauma, importance of FAST and CT scan in a patient with splenic trauma and to study the line of management in special reference to non-operative management. Methods: A retrospective study of 30 splenic injury patients who were admitted under the Department os Surgery, GMCH between June 2012 and May 2013 was done. Data regarding demographic details, mode of injury, investigation findings, management and outcome, hospital stay and follow up were recorded and analyzed. USG (FAST) and CT scan findings were used to grade the splenic injury. Results: 30 patients were included in the study. All patients with Grade I and Grade II injury were managed conservatively. In Grade III injury 5 patients were managed non-operatively and 7 patients operatively. In Grade IV injury 4 patients were managed non-operatively while 2 patients required operative intervention. In Grade V injury, 2 patients needed splenectomy while 2 were treated conservatively. Thus, there is a trend towards non operative management of splenic injury especially in the lower Grades. Conclusions: Non-operative management of splenic injury can be done without increased mortality and morbidity through proper monitoring, rest, blood transfusion and repeated imaging studies especially CT scan.