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>Journals >Cirujano General >Year 2000, Issue 4

Acuña PR, Messa VR
Diagnostic laparoscopy for grade II splenic trauma. Report on one patient.
Cir Gen 2000; 22 (4)

Language: Español
References: 25
Page: 367-370
PDF: 4. Kb.

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Objective: To describe the case of a patient with a grade II splenic lesion diagnosed through laparoscopy, avoiding a non-therapeutic laparotomy.
Setting: Second level health care general hospital.
Case description: A 27 years old man, with bruised abdominal lesions. He had been attacked 16 hours before being admitted to the hospital. He had been hit brutally in the abdomen, hemodinamically stable, pale, without cardiopulmonary alterations, slightly distended abdomen, with generalized muscular resistance, lack of peristalsis, and peritoneal irritation data. Hemoglobin of 8.6 g/dl, thoracic X ray normal, simple abdominal X rays revealed segmentary ileum. Ultrasound revealed free liquid in the abdominal cavity. Diagnostic laparotomy revealed a hemoperitoneum of 1200 ml, grade II splenic lesion, star-shaped, a bruised zone at the visceral side and a subcapsular hematoma, without active hemorrhage. Conservative treatment was applied, leaving drainage. The patient evolved adequately, without needing blood transfusion during the postoperative period. He was left at the hospital for 7 days under absolute rest conditions.
Conclusion: Laparoscopy is useful to study abdominal trauma.

Key words: Laparoscopy, trauma, spleen.


  1. Simón RJ, Ivatury RR. Conceptos actuales de la endoscopia cavitaria para la valoración y el tratamiento de los traumatismos cerrados y penetrantes del tronco. Clin Quirurg Norte Am 1995; 75: 139-55.

  2. Ivatury RR, Simon RJ, Weksler G, Bayard V, Stahl WM. Laparoscopy in the evaluation of the intrathoracic abdomen after penetrating injury. J Trauma 1992; 33: 101-8; discussion 109.

  3. Townsend MC, Flancbaum L, Choban PS, Cloutier CT. Diagnostic laparoscopy as an adjunct to selective conservative management of solid organ injuries after blunt abdominal trauma. J Trauma 1993; 35: 647-51; discussion 651-3.

  4. Rizycki GS. Ultrasonografía abdominal en caso de traumatismo. Clin Quirurg Norte Am 1995; 75: 157-72.

  5. McAnema OJ, Moore EE, Marx JA. Initial evaluation of the patient with blunt abdominal trauma. Surg Clin North Am 1990; 70: 495-515.

  6. Rothlin MA, Naf R, Amgwerd M, Cardinas D, Frick T, Trentz O. Ultrasound in blunt abdominal and thoracic trauma. J Trauma 1993; 34: 488-95.

  7. Josephs LG, Este-McDonal JR, Birkett DH, Hirsch EF. Diagnostic laparoscopy increases intracranial pressure. J Trauma 1994; 36: 815-8; discussion 818-9.

  8. Leppaniemi AK, Kivisaari AO, Haapiainen RK, Lehtonen TA. Role of magnetic resonance imaging in blunt renal parenchymal trauma. Br J Urol 1991; 68: 355-60.

  9. Zantut LF, Ivatury RR, Smith RS, Kawahara NT, Porter JM, Fry WR, et al. Diagnostic and therapeutic laparoscopy for penetrating abdominal trauma: A multicenter experience. J Trauma 1997; 42: 825-29; discussion 829-31.

  10. McKenney M, Lentz K, Nuñez D, Sosa JL, Sleeman D, Axelrad A, et al. Can ultrasound replace diagnostic peritoneal lavage in the assessment of blunt trauma? J Trauma 1994; 36: 439-41.

  11. Johnson SB, Kearneg PA, Smith MD. Ecocardiografía en la valoración de los traumatismos torácicos. Clin Quirurg Norte Am 1995; 75: 173-85.

  12. Koehler RH, Smith RS. Thoracoscopic repair of missed diaphragmatic injury in penetrating trauma: case report. J Trauma 1994; 36: 424-7.

  13. González Rodríguez JA, Escobedo Villarreal MM, Zapata Chavira HA, García Torres EY, Rodríguez MR. Lesiones traumáticas del diafragma. Cir Gen 1995; 17: 94-9.

  14. Zazueta Quirarte E, Córdova Guerrero L, Aguillón Luna A, García Córdova H. Toracoscopia diagnóstica y terapeútica. Experiencia inicial. Cir Gen 1996; 18: 303-7.

  15. Selivanov V, Chi HS, Alverdy JC, Morris JA, Sheldon GF. Mortality in retroperitoneal hematoma. J Trauma 1984; 24: 1022-7.

  16. Wilson TS, Costopoulos LB. Retroperitoneal injury to the duodenum by blunt abdominal trauma: report of eight cases. Can J Surg 1971; 14: 114-21.

  17. Acuña Prats R. Perforación de la segunda porción del duodeno diagnosticada por laparoscopia. Cir Gen 1998; 20: 308-11.

  18. Huang MS, Liu M, Wu JK, Shih HC, Ko TJ, Lee CH. Ultrasonography for the evaluation of hemoperitoneum during resuscitation: a simple scoring system. J Trauma 1994; 36: 173-7.

  19. Liu M, Lee CH, Plen FK. Prospective comparision of diagnostic peritoneal lavage, computed tomographic scanning, and ultrasonography for the diagnosis of blunt abdominal trauma. J Trauma 1993; 35: 267-70; discussion 270.

  20. Forster R, Pillasch J, Zielke A, Malewski U, Rothmund R. Ultrasonography in blunt abdominal trauma: influence of the investigators experience. J Trauma 1993; 34: 264-9.

  21. Grieco JG, Perry JF Jr. Retroperitoneal hematoma following trauma: its clinical importance. J Trauma 1980; 20: 733-6.

  22. Goins WA, Rodríguez A, Lewis J, Brathwaire CE, James E. Retroperitoneal hematoma after blunt trauma. Surg Gynecol Obstet 1992; 174: 281-90.

  23. Taylor GA, Eichelber MR, Odonnell R, Bowman L. Indications for computed tomography in children with blunt abdominal trauma. Ann Surg 1991; 213: 212-8.

  24. Henao F, Aldrete JS. Retroperitoneal hematomas of traumatic origin. Surg Gynecol Obstet 1985; 161: 106-16.

  25. Weigelt JA. Duodenal injuries. Surg Clin North Am 1990; 70: 529-39.

>Journals >Cirujano General >Year 2000, Issue 4

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