Splenectomy for trauma: morbidity, mortality and associated abdominal injuries.
Management of ruptured spleen still frequently requires splenectomy. A retrospective analysis of patients undergoing splenectomy for trauma at Box Hill Hospital, Melbourne, over a 14-year period was conducted; 141 of 145 cases were due to blunt trauma. The mortality rate was 10% and all deaths occurred as a result of road traffic accidents. The overall complication rate was 43%, varying from 25% in those with an isolated splenic injury to 100% with multiple system injuries. There was zero incidence of associated intra-abdominal injury in the group sustaining a ruptured spleen as a result of a fall, assault or sporting injury, in contrast to a nearly 50% incidence following road traffic and bicycle accidents. Whether these associated injuries would have been neglected had laparotomy for splenic trauma not been performed is uncertain, and so non-operative management of splenic trauma remains contentious, particularly in cases following vehicular accidents.
Pitcher
M E
ME
Department of Surgery, Box Hill Hospital, Victoria, Australia.
Cade
R J
RJ
Mackay
J R
JR
D000007:Abdominal Injuries / Q000150:complications* / Q000401:mortality / Q000601:surgery; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications* / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000401:mortality; D013161:Splenic Rupture / Q000150:complications / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000401:mortality / Q000601:surgery*; D014950:Wounds, Penetrating / Q000150:complications / Q000401:mortality / Q000601:surgery