[Surgery strategies for management of gunshot wounds to urogenital system].
The gunshots injuries of the spleen are relative uncommon by comparison with others abdominal trauma. The rate is 1 to 3% of all injuries to the abdomen. This review presents the most widespread classifications of spleen trauma, current diagnostic--physical examination, sonography, CT, DPL, laparoscopy. The surgical treatment is discussed in the following trends--nonoperative and operative approach depending on patient's condition. The nonoperative treatment is applied to hemodynamically stable patients with established superficial lesions and ceased hemorrhage. In the other cases the operative approach is indicated. The splenectomy is the method of choice and in defined situations spleen tissue autotransplantation is applicable. Other procedures are outlined: spleen preserving resections, splenorrhaphy, mesh repair, ligation of sanguinating vessels, omentoplastic, hemostatic glue or mesh, argon plasma electrocoagulation. Most reported complications following spleen trauma are hemorrhage, infections, thrombocytosis, partial necrosis of stomach, pancreatitis, postsplenectomy sepsis. The mortality varies between 5 and 65%.
Kirov
G
G
Aleksandrov
E
E
Smilov
N
N
D006801:Humans; D016896:Treatment Outcome; D014551:Urinary Tract / Q000293:injuries / Q000601:surgery; D013519:Urogenital Surgical Procedures / Q000379:methods*; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000601:surgery