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.
Stolee
R T
RT
Department of Surgery, Gundersen/Lutheran Medical Center, La Crosse, Wisconsin.
Cogbill
T H
TH
Strutt
P J
PJ
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