[Conservative management in blunt splenic trauma].
We reviewed for analysis the charts of two groups of adults patients with blunt splenic injuries issued from two University Hospital Centers; the group 1 (G1) of 22 patients and the group 2 (G2) of 20 patients. The results of actually therapeutic procedures concerning blunt splenic injuries and subsequently the effectiveness of non operative treatment were evaluated. Splenectomy was performed in G1 for 11 patients, instead of 19 patients in G2 (p = 0.0003), whereas, the non surgical treatment was done in 9 patients and 1 patient, respectively (p = 0.02). The mean Splenic Injury Score (SIS) was 2,95 in G1 and 3.47 in G2 (p = 0.03). The spleen was preserved in G1 for 8 patients, instead 1 patient in G2 (p = 0.04). In G1, the non operative treatment was successfully accomplished in 66% of patients. It was obtained with lack of mortality, with a lower overall morbidity and a lower length of hospital stay than in splenectomized patients, but the latter group accounted higher values of Injury Severity Scores (p < 0.05). If proper selection criteria for non operative management are used, more than a third of patients with blunt splenic injury can be treated by splenic preservation at least as safely as splenectomized patients.
Jivănescu
C Bunea
CB
Centrul Clinic de Diagnostic şi Tratament Cluj-Napoca. delia20002002@yahoo.com
Scurtu
R
R
Funariu
G
G
Verhaeghe
P
P
Motocu
R
R
Grecea
D
D
Bumbu
C
C
Gomboşiu
C
C
Ciuce
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D012383:Romania; D013154:Spleen / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*