Modern management of splenic trauma

Hildebrand, Darius; Ben-Sassi, A; Ross, N P; MacVicar, Ronald; Frizelle, Frank; Watson, Adrienne

doi:10.1136/bmj.g1864

Cited by 57 publications

(46 citation statements)

References 58 publications

(31 reference statements)

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“…In comparison, only 40-50% of patients with traumatic splenic injury have historically required operative management, which most typically is splenectomy. 9,10 Thus it appears that if a patient presents with splenic rupture in the absence of trauma, they will be significantly more likely to undergo splenectomy than if their rupture had been of traumatic etiology. Despite the much higher likelihood of splenectomy, we found that most management decisions in cases of ASR were in due course made based on a combination of objective and subjective factors not unlike the traditional indications for splenectomy in traumatic rupture.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of atraumatic splenic rupture

Walker

Foley

2016

Int Surg J

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Section: Discussionmentioning

confidence: 99%

Surgical management of atraumatic splenic rupture

Walker

Foley

2016

Int Surg J

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“…These patients generally undergo immediate operative or non-operative management, depending on the patients' condition and clinicians' judgment (10). The present study analyzed the data of inpatients admitted to Chinese military hospitals with splenic injury, with the aim of identifying the pattern, incidence and management strategies of splenic trauma.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and management of splenic injury: An analysis of a Chinese military registry

Yong

Qiu

Yang

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. In China, there have been few meta-analyses of the epidemiology and management of splenic injury. Due to the success of Chinese military hospitals in the domestic treatment of splenic injury, the present study conducted a systematic review of such cases, identifying a high occurrence rate of splenic trauma, as well as a number of strategies of managing splenic injury in China. Data were collected from sixteen Chinese military hospitals between July 2000 and March 2009, and retrospectively reviewed. It was observed that between July 2000 and March 2009 a total of 7,807 patients (84.32% male and 15.68% female) with splenic injury were admitted to hospital. The mean duration of hospital stay was 17.9±18.6 days and the gender distribution of splenic injury over the successive years did not differ significantly (P>0.05, c= 0.034). However, there was a significant difference in the gender distribution of splenic injury patients in different months (P<0.05, c=0.063). In addition, admission numbers for splenic injury were highest in September, October and November. It was also found that splenic injury may occur at all ages, though patients of working age (20-50 years), which comprises 85.59% of patients, the highest proportion of all recorded cases. Associations between mortality rate and each management strategy were as follows: Operative management, 0.11% and non-operative management, 0.15%. Furthermore, multivariate analysis demonstrated that transfusion, New Injury Severity Score and management strategies were all correlated with mortality rate. Thus, despite a lack of data for inpatients from civilian hospitals, the present study has, in part, identified the epidemiology and management strategies of splenic injury in China. These findings may supplement those from previous analyses of splenic injury in other countries and regions.

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“…The patients with splenic injury may present with either left hypochondrium pain associated with left shoulder tip pain or diffuse abdominal pain. It has been shown that left lower chest injury presents in 43% of patients with splenic injuries [4]. The mortality resulting from splenic injury increases if there are associated injuries of other organs, increased injury severity score and increased age.…”

mentioning

confidence: 99%

“…However, if angiography is not available, contrast CT and MRI are proved to be very useful [5] [6]. CT scan is considered the gold standard for imaging blunt abdominal trauma, and identification of splenic injuries [4].…”

mentioning

confidence: 99%