[Traumatic hemoperitoneum of splenopancreatic origin. Apropos of 155 cases. Can a non-surgical treatment be proposed?].
From 1985 to 1990, we treated 155 patients presenting with a hemoperitoneum secondary to a splenic or hepatic injury (diagnosis established by sonography, puncture and washout and/or laparotomy). These were 39 children and 116 young adults (average age 33 years). Fifty-eight of them (37%) suffered from multiple injuries (11 children, 47 adults). Splenic lesions were observed in 110 cases and hepatic lesions in 45. Ninety-one patients were operated, 55 in emergency and 36 later, while a watch-and-wait policy was applied to 64 (42%), with repeated clinical and complementary (ultrasound and/or CT) examinations. The indication for surgery was based on the clinical findings and the necessity of blood transfusion (more than 40 ml/kg/24 h in children, more than 2 to 5 U/24 h in adults, according to the context). This attitude allowed us to avoid operating two-thirds of the children and one third of the adults. We assess the limitations of this method.
Le Neel
J C
JC
Clinique chirurgicale A, Hôtel-Dieu, Nantes.
Guiberteau
B
B
Khosrovani
C
C
Bochereau
C
C
Kohen
M
M
Plattner
V
V
Héloury
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006465:Hemoperitoneum / Q000209:etiology* / Q000628:therapy; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012306:Risk; D013154:Spleen / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy; D013536:Suture Techniques
Les hémopéritoines traumatiques d'origine spléno-hépatique. A propos de 155 cas. Peut-on proposer un traitement non opératoire?