Laparoscopic Treatment of Splenic Injuries.
The spleen is the intrabdominal organ that is commonly injured after blunt abdominal trauma. The use of laparoscopy to diagnose intrabdominal lesions after abdominal trauma has been recommended for many years, but not until the explosive diffusion of laparoscopic cholecystectomy did it attract the interest of surgeons. Standard diagnostic methods for assessment of splenic rupture are peritoneal lavage, computed tomography scan, and ultrasonography. Based on the clinical picture and results of these tests, a conservative policy for splenic trauma is possible in some cases, but these diagnostic methods have a number of shortcomings that may be overcome by laparoscopy. Recents reports confirm that laparoscopy for abdominal trauma carries a high diagnostic yield in the identification of intra-abdominal injuries, and by exclusion of significant intra-abdominal trauma, it reduces the negative laparotomy rate. Therapeutic laparoscopy can be used to deal with mild splenic lesions in stable patients and in the treatment of late consequences of splenic injury, such as post-traumatic cysts.
Service of Surgery, Hospital Clinic, Barcelona, Spain
EM
Targarona
M
Trías