Conservative management of splenic injury in the tropics

Abstract

We undertook this study in order to determine whether the conservative management of splenic injuries is a safe practice in a low-volume tropical hospital. We evaluated 69 consecutive patients with splenic injury prospectively. The outcome measures were morbidity and mortality rates, overall hospital stay and blood transfusion requirements. Spleen preservation was achieved in 85% (59) of cases. Of the 16 patients who underwent splenic surgery, six had splenorraphy (38%). The overall mortality was 4.3% (3) and the deaths were not related to the conservative management. Our findings suggest that not only is the conservative management of splenic injuries safe, but also that the repair of an enlarged spleen (splenorrhaphy) is safe and feasible in tropical hospital settings. The findings in this study provide further evidence that the conservative management of splenic injury in a tropical hospital without computed tomography scan is a safe practice.

Çocuklarda dalak yaralanmalarının geriye dönük değerlendirilmesi: Tek bir merkezde on yıllık deneyim

“…There are increased risks of infection and sepsis who had a splenectomy, so NOT is indispensable for children particularly. Kuzma et al [8] reported mean systolic blood pressure in a NOT group as 98 mmHg and in a surgically treated group as 84 mmHg. We detected the same parameter at the level of 105 mmHg in group I and 95 mmHg in group II; mean diastolic blood pressures were 70 mmHg in group I and 65 mmHg in group II.…”

“…Blood transfusions were performed in four patients (12%) in the nonoperative group and in five patients (83%) in the operative group in Thompson et al study. Jerzy et al [8] indicated that patients in the NOT group needed 0.81 unit of blood and the OT group they needed 2.91 units of blood (p<0.001). In this study the rate of blood transfusion in group I was 45% and in group II it was 100%.…”

“…Fights and sports accidents are the most common causes of solid organ injuries in adults while falls from height, traffic and bicycle accidents and falling objects are the most frequent causes of injury in children. [8] Our study included patients who had traumas because of accidents involving a motorized vehicle (37, 48.7%), falls from height (21, 27.6%), sports/bumping into obstacles (14, 18.3%), a crash object in the abdomen (3.3, 9%), kick from a horse 1 (1.3%).…”

Advantages of isolated application of fibrin glue over suture in preservation of second-grade spleen lesion

“…So far, many surgical procedures of the spleen have been described in previous literature (application of haemostatic agents, segmental resection, mesh-splenorrhaphy, stapler resection and auto-transplantation) (14)(15)(16)(17).…”