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2008, Number 1

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Cir Gen 2008; 30 (1)

Management alternatives for splanchnic injuries

Pérez PJE

Language: Spanish
References: 43
Page: 41-47
PDF size: 89.38 Kb.


ABSTRACT

Objective: To communicate the experience of the author in the diverse available methods to preserve the spleen in patients with splenic trauma.
Setting: General Surgery Service. Regional General Hospital No. 6, Mexican Institute of Social Security (IMSS, for its initials in Spanish). Ciudad Madero, Tamaulipas, Mexico
Design: Descriptive, retrospective analysis in a series of 13 patients.
Statistical analysis: Percentages as summary measure for qualitative variables.
Patients and methods: Thirteen patients, aged 8 to 72 years, with splenic trauma. Assessed variables were: degree of splenic injury, surgical procedure performed to avoid splenectomy, whether or not hemostasis was achieved with spleen preservation, morbidity, and mortality.
Results: Spleen injuries grade I in one patient, grade II in nine, III in one, and V in two. There were five patients (38.5%) with severe concomitant injuries. All patients were subjected to surgical procedure with preservation of the splenic parenchyma; autologous transplant in two (15.4%), splenorhaphy in 10 (77%), and segmentary resection followed by splenorhaphy in one (7.7%). Complete hemostasis was achieved in all cases. There were two postoperative complications (15.4%), both patients presented severe concomitant injuries that were resolved favorably. Two patients (15.4%) died as a consequence of severe associated neurological injuries. There were no deaths directly related with the spleen injuries nor with their management.
Conclusion: The surgeon must make an effort to perform surgical procedures that allow preserving the spleen, as complete hemostasis can be achieved with moderate morbidity and without mortality directly related to the treatment of the splenic injuries.


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