Laparoscopic Repair of Penetrating Splenic Injury

Abstract

Historically, all splenic injuries were treated with splenectomy. In recent decades, however, there has been a trend toward splenic conservation methods in an attempt to preserve immunologic functions. Although cases of splenic conservation in the setting of penetrating injuries exist in the literature, this method of management is more commonly attempted in blunt traumas. When presented with penetrating splenic trauma, surgeons generally still proceed directly to exploratory laparotomy with splenectomy. Splenic injuries are rarely repaired with splenorrhaphy due to surgeon inexperience and concern for reoperation. We conclude from this case that when presented with a penetrating splenic trauma in a hemodynamically stable patient, management by laparoscopic exploration with splenorrhaphy can be safe and effective.

Operative and Nonoperative Management; Children with Abominal Gunshot Injuries

“…Therefore, minimally invasive techniques, such as laparoscopic vascular embolization or splenography, may be preferentially performed over NOM in patients with splenic injury. [26] Despite diagnostic difficulties, using diagnostic CT to facilitate the decision to operate in cases of GSW is quite safe in patients with hemodynamic instability and signs of peritonitis upon serial abdomen examination. GSW causes surrounding organ damage by dispersing kinetic energy throughout the track of the bullet.…”