The injured spleen: should consideration be given to conservative management?
This report is a retrospective study over a 13 year period of 267 patients who underwent splenectomy. The incidence of associated major abdominal injuries following blunt trauma in these patients was 8%. Over half of these associated injuries were diagnosed pre-operatively. Sixty-nine per cent of the patients were haemodynamically stable before operation. Patients who suffered splenic injuries whilst playing sport or who were conscious and did not have major extra-abdominal injuries or clear evidence of other intra-abdominal injury could possibly have been managed expectantly. Such a policy might have avoided splenectomy in a substantial number of cases and thus have eliminated the risk of Overwhelming Post-Splenectomy Infection (OPSI) in these patients.
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D001265:Athletic Injuries / Q000601:surgery; D002648:Child; D006439:Hemodynamics; D006801:Humans; D007902:Length of Stay; D008297:Male; D008722:Methods; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D012422:Rupture, Spontaneous; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy; D013158:Splenic Diseases / Q000601:surgery*; D013997:Time Factors; D014474:Unconsciousness; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery; D014950:Wounds, Penetrating / Q000601:surgery