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2019, Number 2

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Cir Gen 2019; 41 (2)

Splenectomies for abdominal trauma in a Second Level General Hospital. 5-year analysis

Padrón AG

Language: Spanish
References: 31
Page: 79-85
PDF size: 191.41 Kb.


ABSTRACT

Introduction: Approximately a quarter of the closed abdominal traumas present spleen injury and a high index of clinical suspicion is required along with the help of the imaging studies to be able to decide to operate because when these patients are carefully chosen and it is decided not to operate, this is related to a low morbidity and mortality rate. Material and method: The demographic variables were obtained: age and sex; etiology; Laboratory tests: group and Rh, Hemoglobin, arterial blood gases; Cabinet studies: (US, TAC), admission to ICU, intra-hospital stay and morbidity. Results: During the study period, twelve splenectomies were performed for open (2) or closed (10) abdominal trauma and 5 of them with thoraco-abdominal injury. Four required packing, eight had no other morbidities. Discussion: Zarzaur BL et al. have established that the risk factors in a patient who does not undergo operation are age › 55 years, degree of the injury and hemoperitoneum volume (moderate 250 to 500 ml, severe › 500 ml), concomitant lesions to other solid organs and vascular anomalies. Hemodynamic instability (which they define as blood pressure ‹ 90 mmHg and heart rate › 130 beats per minute), is an indication to operate immediately. Conclusions: In our hospital, all cases were managed with total splenectomy because they presented additional hepatic, renal, intestinal, and/or diaphragmatic damage that justified the surgical intervention and we did not consider the preservation of the spleen.


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