Sánchez SA

Language: Spanish
References: 7
Page: 7-13
PDF size: 45.85 Kb.

ABSTRACT

This is a retrospective clinical research study, where we study a population of 140 patients suffering from splenic trauma during the period going from May the first to February the 28th, in Hospital General Balbuena. There was a prevalence of male patients, and 83 cases of contused trauma (59.3%), 53 of open trauma (37.8) and 4 of iatrogenic trauma (2.9%). The grade of lesion was determined, its way of treatment based upon this graduation, and associated lesions depending on their generation mechanism, their morbidity and mortality or death rate. In contused trauma were found grade I lesions in three cases, grade II in 16 cases, grade III in 19 cases and 45 in grade IV. In case of acute, piercing or penetrating trauma there were one grade I lesion, 16 grade II, 12 grade III and 24 grade IV, being grade II and III lesions caused by gun projectiles the most common ones. Splenic salvagings based upon raphy were observed in grades I and II, and splenectomies were found in grades III and IV. In general, a guard drainage was applied during 24 hours in four cases (2.9%), the same treatment plus splenorraphy in 21 (15%), splenectomy in 115 (82.1%), and in 3 cases (2.1%) spleen autoimplant was practiced. Lesions associated to spleen hurt were mainly found in cases of liver contusion and in case of penetrating trauma of left hemidiaphragm . Splenic trauma was only observed in 19.2% of the patients. Death occurred in 26 cases (18.5%) specially due to contused trauma (16.4%). Death cause mainly happened cause of hypovolemic shock There were complications in 4 cases (1.4%) in patients who had been practiced splenorraphy, in 2 cases with postoperative bleeding (1.4%), one (0.7%) with surgical infection and another one with spleen abscess. There were 4 cases with late detection, with clinic and ultrasonic failure; in one case it was found associated craneoencephalic trauma, which got early diagnosis to be difficult. Additional spleen presence were reported in 10 cases (7.1).There was no further observation in patients having been practiced spleen autoimplant.

REFERENCES

1. Sherman R. Justificación y método para la conservación del bazo. Clínicas Quirúrgicas de Norteamérica. 1981: 1.

2. Francke EL. Infecciones posesplenectomía. Clínicas Quirúrgicas de Norteamérica. 1981: 1.

3. Shackford SR, Molin M. Tratamiento de lesiones del bazo. Clínicas Quirúrgicas de Norteamérica. Trauma Abdominal. Ed. Interamericana. 1990; 3: 603-628.

4. Skandalakis PN et al. Anatomía quirúrgica del bazo. Clínicas Quirúrgicas de Norteamérica. Ed. Interamericana. Anatomía y Embriología Quirúrgicas. 1993; 4: 791-811.

5. Moore EE, Cgbill TH. Organ injury scaling; spleen and liver. Journal of Trauma 1995; 38: 223.

6. Esposito TJ, Gamelli RL. Trauma. 3a. edición. Appleton & Lange. Stamford Conecticut. 1998: 525-547

7. Estadísticas del Servicio de Cirugía General, Hospital General Balbuena.