Experience of selective conservatism in splenic trauma

ABSTRACT

A review of all patients with splenic trauma managed at a teaching hospital in the year 1995 is presented. Out of a total of 38 patients, thirty four [89.5%] were male. Most of the victims were young [mean age 28 years]. Eighteen patients [47.7%] had firearm injury, 11 [28.9%] had stab wound and 9 [23.7%] had blunt abdominal trauma. The average interval between the injury and presentation was four hours. The severity of injury was classified according to revised splenic injury scale. Six [15.8%] patients had grade I, 5 [13%] had grade II, 8 [21%] had grade III, 12 [31.6%] had grade IV and 4 [10.5%] had grade V injuries. Thirty one [81.6%] patients had associated injuries to other organs. Thirty five [92%] patients were operated. Splenectomy was performed in 22 [58%] patients, 6 cases had splenorrhaphy, and 5 [13.2%] had partial Splenectomy. Three [8%] otherwise stable patients where diagnosis was confirmed on ultrasonography were treated conservatively. There was no incidence of delayed Splenectomy. The overall mortality rate was 15.5%. However, there was no mortality in those treated conservatively. Mean hospital stay was 8 days