The injured spleen: should consideration be given to conservative management?

Aust N Z J Surg. 1984 Apr;54(2):129-35. doi: 10.1111/j.1445-2197.1984.tb06703.x.

Abstract

This report is a retrospective study over a 13 year period of 267 patients who underwent splenectomy. The incidence of associated major abdominal injuries following blunt trauma in these patients was 8%. Over half of these associated injuries were diagnosed pre-operatively. Sixty-nine per cent of the patients were haemodynamically stable before operation. Patients who suffered splenic injuries whilst playing sport or who were conscious and did not have major extra-abdominal injuries or clear evidence of other intra-abdominal injury could possibly have been managed expectantly. Such a policy might have avoided splenectomy in a substantial number of cases and thus have eliminated the risk of Overwhelming Post-Splenectomy Infection (OPSI) in these patients.

Publication types

  • Comparative Study

MeSH terms

  • Accidents, Traffic
  • Adolescent
  • Adult
  • Aged
  • Athletic Injuries / surgery
  • Child
  • Hemodynamics
  • Humans
  • Length of Stay
  • Male
  • Methods
  • Middle Aged
  • Retrospective Studies
  • Risk
  • Rupture, Spontaneous
  • Spleen / injuries*
  • Splenectomy
  • Splenic Diseases / surgery*
  • Time Factors
  • Unconsciousness
  • Wounds, Nonpenetrating / diagnosis
  • Wounds, Nonpenetrating / surgery
  • Wounds, Penetrating / surgery