Blunt Splenic Trauma

Forsythe, Raquel M.; Peitzman, Andrew B.

doi:10.1177/145749690609500303

Cited by 29 publications

(26 citation statements)

References 47 publications

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“…The overall mortality rate from splenic injury was reported as 6-7% or high in many series and this mortality rate is secondary to associated injuries. [216–19] Researchers noted that the most common cause of splenic injury was blunt abdominal trauma. Most of the blunt abdominal traumas were secondary to falls from heights and road traffic accidents.…”

Section: Discussionmentioning

confidence: 99%

Blunt splenic injury in Sikkimese children and adolescents

Mohanta

Ghosh

Pal

et al. 2011

J Emerg Trauma Shock

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Background:The contemplation for the salvage operations and the nonoperative treatment for the pediatric splenic injuries had increasingly been suggested as the standard case management.Objectives:The study was carried out to identify the risk factors, the presentations, the severities and outcome of the interventions of blunt splenic injuries in the children and adolescents.Materials and Methods:This retrospective review was carried out in a tertiary care hospital in Sikkim on the children and adolescents admitted with splenic injury from January 2005 to December 2009. Splenic injuries were graded with the American Association for the Surgery of Trauma Splenic Injury Scale followed by the operative and nonoperative managements (NOM).Results:Overall 147 cases with the abdominal trauma were diagnosed with splenic injury. Of them, males reported in higher numbers; three-fourths were adolescents with preponderance above 16 years of age. Majority of the cases [n=91(61.90%)] were due to fall from heights and others from road traffic accidents. Immediate surgical interventions was instituted in the hemodynamically unstable cases (n=87) NOM failed in 27 patients; of them eight cases underwent splenectomy, and 19 underwent surgical salvage; 33 were closely followed up by conservative approach with both clinical and CT criteria. Total number of cases in grade III and above was significantly higher than with lower grades of injury.Conclusions:In total 95(64.63%) of the cases were managed with total splenectomy; 19 cases in the initial nonsurgical group underwent salvage operation and 33 cases received NOM.

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Section: Discussionmentioning

confidence: 99%

Blunt splenic injury in Sikkimese children and adolescents

Mohanta

Ghosh

Pal

et al. 2011

J Emerg Trauma Shock

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“…In this case splenectomy was not performed for the haemolytic anaemia per se but because of abdominal blunt trauma to a massively enlarged spleen to avoid delayed splenic rupture, which is a potentially life-threatening complication. Five per cent of post-traumatic splenic ruptures can be missed, even by CT 12. It might be not enough to rely on imaging alone because 18% of spontaneous post-traumatic splenic ruptures are found to have histopathological findings which could have contributed to the rupture 13.…”

Section: Discussionmentioning

confidence: 99%

Splenectomy complicated by sustained extreme thrombocytosis and extensive portosplenomesenteric vein thrombosis in pyrimidine 5′-nucleotidase deficiency

et al. 2013

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Reactive and redistributional thrombocytosis is a well-known postsplenectomy occurrence .Usually it is transient and it rarely reaches extreme levels. We report a rare case of haemolytic anaemia where splenectomy was carried out following trauma to a massively enlarged spleen and was followed by extreme sustained thrombocytosis associated with extensive portal, splenic and mesenteric vein thrombosis despite standard antithrombotic prophylaxis.

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“…DPL is a diagnostic technique that can be used for diagnosis of blunt abdominal traumas, and it can identify hemoperitoneum with 97% sensitivity. [17] However, it cannot give information about the source of the hemorrhage. If the spleen trauma is identified by US or CT, we do not perform DPL in our clinic.…”

Section: Discussionmentioning

confidence: 99%