Management of splenic trauma

ABSTRACT

This work included 90 patients with splenic trauma, 76 [84.4%] males and 14 females [15.6%]. Ages varied between 5 and 50 years with a median of 19.4 years. The highest peak lies between 11 and 20 years. On analysis of the cases of trauma, the patients were divided into 5 groups. Falling from a height accounts for the highest number of cases which was 32 [35.5%] followed by road traffic accidents [24 cases] [26.6%], stab-injuries due to civilian violence accounted for 12 cases [13.3%], fire-arm injuries were seen in 8 cases [8.8%]. Other causes including blunt violence [6 cases] and iatrogenic injuries [8 cases] had good participation. Diagnosis based on rapid history and clinical evaluation with ultrasound examination of all patients. Laboratory tests played a minor role for diagnosis. 28 patients underwent splenectomy. 16 patients were subjected to splenerrhaphy, partial splenectomy was done in 20 cases and splenic autotransplants [after splenectomy] was done in 26 cases. Early postoperative complications were minor and none of the patients died in the early postoperative period. All patients were followed every 3 months for detection of remanents of splenic tissue and for detection of post-splenectomy infection. Only one case of over-whelming post- splenectomy infection [OPSI] was picked-up [following splenic autotransplantation]. It was clear that splenic preservation techniques can be safely done. The impetus is the recognized risk of [OPSI] especially in the pediatric group