Changing Patterns in the Management of Splenic Trauma

Pachter, H. Leon; Guth, Amber; Hofstetter, Steven R.; Spencer, Frank C.

doi:10.1097/00000658-199805000-00011

Cited by 261 publications

(219 citation statements)

References 28 publications

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“…NOM failure increased length of hospital stay and increased mortality in selected subsets of patients (9,32). Accordingly, NOM has shorter length of hospital stay than operative management in patients with isolated solid organ injuries (30).…”

Section: Discussionmentioning

confidence: 99%

Independent Risk Factors for Failure of Nonoperative Management in Patients with Splenic Injury

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Independent Risk Factors for Failure of Nonoperative Management in Patients with Splenic Injury

et al. 2015

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“…Although catastrophic injury is uncommon, it is possible many asymptomatic injuries to the spleen go undetected. Hemodynamically stable patients with splenic injuries after blunt trauma are successfully treated nonoperatively in greater than 70% of cases [5].…”

Section: Discussionmentioning

confidence: 99%

Case Reports: Splenic Rupture after Anterior Thoracolumbar Spinal Fusion Through a Thoracoabdominal Approach

Heyworth

Schwab

Boachie-Adjei

2008

Clin Orthop Relat Res

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The anterior approach in spinal deformity surgery has increased in popularity in recent years. The thoracoabdominal approach to the thoracolumbar spine is associated with numerous possible complications, including injury to vital intraabdominal structures in close proximity to the area of exposure, such as the spleen. We describe the case of a 44-year-old woman who underwent an emergent exploratory laparotomy for progressive abdominal pain and hemodynamic instability that revealed splenic rupture two days after single-stage anterior spinal fusion with instrumentation for thoracolumbar kyphoscoliosis. Because the suspected etiology of the splenic hemorrhage was related to retraction, surgeons using the anterior approach should consider intermittent release of retractors and inspection of intraabdominal structures. Splenic rupture should be considered as part of the differential diagnosis for patients with hemodynamic instability after anterior approaches to the thoracolumbar spine.

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“…Classic criteria for nonoperative management include haemodynamic stability, absence of other clear cut indications for laparotomy or associated injuries requiring surgical intervention, absence of health conditions that carry increased risk of bleeding, grade I-III injuries and patients under 55 years of age. 15 Myers et al reported successful management of solid visceral injuries irrespective of grades, in haemodynamically stable patients of age more than 55 years. 96 So the choice between operative and nonoperative treatment should be guided primarily by haemodynamic considerations rather than grades or severity of organ injury.…”

Section: Managementmentioning

confidence: 99%

Clinico epidemiological study of blunt abdominal trauma in a tertiary care hospital in north western Himalayas

et al. 2017

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Background: Blunt abdominal trauma (BAT), a common form of trauma, is one of the major causes of morbidity and mortality. The study was aimed at the study of spectrum of injuries to various intra-abdominal organs after blunt trauma and to ascertain cause/mode of BAT in a hospital of hilly locality of Shimla.Methods: A prospective study was designed to conduct in the department of Surgery, IGMC, Shimla, India during the period of one year from 1st June 2005 to 31st May 2006. A total of 30 patients who had sustained BAT with or without other associated injuries were selected. In all patient’s history was taken and detailed physical examination done while concomitant resuscitation was performed. Chest and abdominal radiographs were done in all patients.Results: BAT is a major cause of morbidity and mortality especially in young people in the 11-40 years’ age group. Males are affected more than females. Road traffic accidents are the predominant mode of injury however, a relatively high incidence of blunt abdominal trauma due to falls is observed in a hilly state like ours. Spleen and liver are the two commonly injured organs after blunt abdominal trauma.Conclusions: Proper early diagnosis with initial and adequate resuscitation is beneficial in having a good outcome in patients of BAT.

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Changing Patterns in the Management of Splenic Trauma

Cited by 261 publications

References 28 publications

Independent Risk Factors for Failure of Nonoperative Management in Patients with Splenic Injury

Independent Risk Factors for Failure of Nonoperative Management in Patients with Splenic Injury

Case Reports: Splenic Rupture after Anterior Thoracolumbar Spinal Fusion Through a Thoracoabdominal Approach

Clinico epidemiological study of blunt abdominal trauma in a tertiary care hospital in north western Himalayas

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