Laparoscopic splenectomy in blunt trauma: is the procedure safe in pregnant patient?
There are increasing reports about laparoscopic splenectomy being performed even in blunt trauma patients, especially when conservative treatment has failed, but there are very rare reports involving pregnant patients operated laparoscopically due to a blunt trauma. The fear of possible injury of the fetus and effects on the course of the pregnancy limited the use of laparoscopic surgery in pregnant trauma patients. We report here a case of the laparoscopic splenectomy performed in a pregnant patient who sustained a blunt abdominal trauma, with grade V splenic injury. After diagnostic laparoscopy, which revealed the presence of a large amount of free fluid in the abdomen and a lesion on hilum of the spleen, laparoscopic splenectomy was performed with vascular staple. The patient had an uneventful recovery and was discharged with no discernible effects on the course of the pregnancy. This case shows that laparoscopic splenectomy is feasible and a safe procedure in pregnant patients who sustained a blunt abdominal trauma, but it requires adequate experience in elective laparoscopic surgery of spleen, continuous monitoring of fetal vitality is required.
Latic
Ferid
F
Department of Surgery, County Hospital Slavonski Brod, Croatia.
Delibegovic
Samir
S
Latic
Azra
A
Miskic
Djuro
D
Pitlovic
Vlatka
V
Koluh
Anhel
A
D000007:Abdominal Injuries / Q000601:surgery; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy; D014949:Wounds, Nonpenetrating / Q000601:surgery*