A retrospective analysis of timing of mobilisation and start of enteral feeding in 19 patients treated non-surgically for splenic trauma.
OBJECTIVE
Analysis of outcome in terms of the moment at which mobilisation and enteral feeding may be started in patients undergoing non-surgical treatment for splenic trauma.


METHODS
19 patients, median age 29 years, admitted to our hospital between 1988 and 1993. The diagnosis of splenic trauma was confirmed by abdominal computerized axial tomography and the lesions classified according to severity. Initial clinical and paraclinical diagnostic indices, evolution, duration of bed-rest and of nil by mouth-regimen, clinical follow-up at 30 months were recorded.


RESULTS
12 patients had type I or II lesions and 6 had type III lesions according to the Buntain classification [5]. 2 patients with type III lesions underwent laparotomy on the 4th day posttrauma. 11 patients had other associated lesions and 12 were admitted to the surgical intensive care unit (SIC). Bed rest was continued for an average of 2.7 days and enteral nutrition was restarted an average of two days after trauma when bowel sounds reappeared. All patients survived to leave hospital and 90% were alive at 30 months.


CONCLUSIONS
Mobilisation and enteral feeding in patients treated non-surgically for Buntain type I, II and III splenic lesions should be restarted as soon as the clinical course allows.
Pacetti
G
G
Department of Surgery, University Hospital of Geneva.
Romand
J A
JA
Aguillar
M
M
Donald
F
F
D000007:Abdominal Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004434:Early Ambulation; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries*; D013156:Splenectomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000628:therapy*