Traitement des traumatismes de la rate

Les traumatismes de la rate ont quelques fois pose de difficiles problemes de diagnostic et d'indications operatoires pour le chirurgien generaliste. Ces dernieres annees; deux grandes tendances se degagent de nombreuses publications consacrees a ce sujet : une precision diagnostique de plus en plus grande liee a l'amelioration des techniques d'imagerie medicale; et une attitude therapeutique de moins en moins agressive; c'est-a-dire de moins chirurgicale; liee egalement a la precision du diagnostic et a un meilleur suivi des patients. Devant l'engouement que peut susciter cette derniere tendance therapeutique chez les chirurgiens des milieux sous-equipes comme ceux du Zaire; il a paru interessant de faire une mise au point afin de degager l'attitude therapeutique la mieux adaptee a cet environnement

Tropical Surgical abdominal emergencies blunt splenic rupture in Calabar

A detailed study of splenic rupture in 34 consecutive patients living in souttheastern equatorial rainforest Nigeria was conducted during a 5-years period. The results clearly show that blunt abdominal injury from road traffic accident (RTA) was the cause of rupture in the vast majority of cases. Road traffic accident was due in many cases to collision with a motor bike which is a popular means of transportation in this region. Although the external injury to the abdomen was slight; and in some cases nil; the ensuing trauma to the spleen was extensive. In contrast RTA due to the motor car; seen in 5 of the 34 patients studied; caused much associated injury to the patient. The pattern of splenic rupture seen in this tropical African community is out-standingly in contrast with that of the developed countries of the West where spontaneous rupture of diseased spleen seems to be common