[Traumatic hemoperitoneum of splenopancreatic origin. Apropos of 155 cases. Can a non-surgical treatment be proposed?]

Chirurgie. 1991;117(5-6):437-44.
[Article in French]

Abstract

From 1985 to 1990, we treated 155 patients presenting with a hemoperitoneum secondary to a splenic or hepatic injury (diagnosis established by sonography, puncture and washout and/or laparotomy). These were 39 children and 116 young adults (average age 33 years). Fifty-eight of them (37%) suffered from multiple injuries (11 children, 47 adults). Splenic lesions were observed in 110 cases and hepatic lesions in 45. Ninety-one patients were operated, 55 in emergency and 36 later, while a watch-and-wait policy was applied to 64 (42%), with repeated clinical and complementary (ultrasound and/or CT) examinations. The indication for surgery was based on the clinical findings and the necessity of blood transfusion (more than 40 ml/kg/24 h in children, more than 2 to 5 U/24 h in adults, according to the context). This attitude allowed us to avoid operating two-thirds of the children and one third of the adults. We assess the limitations of this method.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Transfusion
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hemoperitoneum / etiology*
  • Hemoperitoneum / therapy
  • Hepatectomy
  • Humans
  • Liver / injuries*
  • Liver / surgery
  • Male
  • Middle Aged
  • Risk
  • Spleen / injuries*
  • Spleen / surgery
  • Splenectomy
  • Suture Techniques