Non-operative management of adult blunt splenic injuries.
OBJECTIVE
To investigate the indication of non-operative management of adult blunt splenic injuries.


METHODS
A retrospective review was performed on all adult patients (age>15 years) with blunt splenic injuries admitted to the department of vascular surgery of Pellegrin hospital in France from 1999 to 2003. We managed splenic injuries non-operatively in all appropriate patients without regard to age.


RESULTS
During the 4 years, 54 consecutive adult patients with blunt splenic injuries were treated in the hospital. A total of 27 patients with stable hemodynamic status were treated non-operatively at first, of which 2 patients were failed to non-operative treatment. The successful percentage of non-operative management was 92.6%. In the 54 patients, 7 of 8 patients older than 55 years were treated with non-operative management. Two cases developing postoperatively subphrenic infection were healed by proper treatment. In the series, there was no death.


CONCLUSIONS
Non-operative management of low-grade splenic injuries can be accomplished with an acceptable low-failure rate. If the clinical and laboratory parameters difficult for surgeons to make decisions, they can depend on Resciniti's CT (computed tomography) scoring system to select a subset of adults with splenic trauma who are excellent candidates for a trial of non-operative management. The patients older than 55 years are not absolutely inhibited to receive non-operative management.
Yang
Jun
J
Department of Traumaology, Chongqing Emergency Medical Center, Chongqing 400014, China.
Gao
Jin-mou
JM
Jean-Claude
Baste
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000628:therapy; D012189:Retrospective Studies; D013154:Spleen / Q000293:injuries* / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000601:surgery / Q000628:therapy*