Trends in the management of splenic trauma.
During the 20-year period ending December 1987, 179 consecutive splenic trauma patients were treated at a single institution. Procedures included splenectomy in 121 (67%) patients, splenectomy with autotransplantation in 7 (4%), splenorrhaphy in 23 (13%), laparotomy alone in 7 (4%), and nonoperative management in 21 (12%). Before 1976, all patients were treated by splenectomy. Since 1980, 18 (22%) were treated nonoperatively, 26 (33%) by splenic salvage techniques, and 36 (45%) by splenectomy. We conclude that nonoperative therapy and splenic salvage techniques are being employed with increasing frequency. Selective application of splenorrhaphy for injuries with a realistic expectation of success has resulted in no late procedures for hemorrhage. In the presence of severe splenic or associated injuries, splenectomy remains the procedure of choice.
Department of Surgery, Gundersen/Lutheran Medical Center, La Crosse, Wisconsin.
R T
RT
Stolee
T H
TH
Cogbill
P J
PJ
Strutt
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000293:injuries* / Q000601:surgery / Q000637:transplantation; D013156:Splenectomy; D013536:Suture Techniques
D006490:Hemostatics