EXPERIENCE WITH SPLENIC TRAUMA IN AYUB TEACHING HOSPITAL, ABBOTTABAD
Abstract
Background: This study was carried out to estimate the prevalence, severity and mode of splenictrauma and management technique from amongst the abdominal trauma cases admitted in AyubTeaching Hospital Methods: The study was carried out at Surgery units of Ayub TeachingHospital, Abbottabad, the only referral hospital for major trauma cases, from July 2001 to Dec.2002. One hundred consecutive abdominal trauma patients admitted to all surgical units whichwere followed up through complete documentation were included in the study. Their injurieswere classified, treatment strategies outlined and complications were documented. Results: Out ofthe 100 patients presenting in emergency, 25% presented with blunt and 75% with penetratingtrauma. 97 patients underwent laparotomy and 03 treated conservatively. Mean age was 27.26(range 19-49) years. Out of these cases 19 patients had splenic injury, 6 (31.57%) with Type-I & IIwhile 13 (68.42%) with Type-III & IV. 11(57.89%) of the splenic injuries were due to bluntabdominal trauma and 8 (42.10%) due to penetrating abdominal injuries. 14 (83.6%) of thepatients with splenic injury underwent splenectomy and 5(26.3%) splenorrhaphy. Conclusion:The commonest cause of splenic injury was blunt abdominal trauma; Assessment of the severityof splenic injuries at the time of laparotomy resulted in splenic salvage procedures in some cases.Splenorraphy was associated with fewer complications.Keywords: Spleen; Trauma; Splenic SalvageReferences
Cooper MJ. Williamson RCN. Splenectomy: indications
hazards and alternatives. Br J Surg 1984;71:173-80.
Muhammad G, Ahmad S. Splenectomy indications hazards
and alternatives. J Ayub Med Coll Abbottabad 1988;1:34-9.
Kamel R, Manar ET, Kamel RR. Surgery of the spleen:
splenic conservation. J Surg Pakistan. 2000;5:20-8.
Memon AA, Ansari AG, Memon AQ. Indications for
splenectomy and changing concepts. J Surg Pakistan
;5:7-9.
Javed NQ, Zahid AQ, Parkash A, Abdul SM. Gunshot
perforation of gut and associated injuries. J Surg Pakistan
;6:21-3.
Ayub H. Assessment of blunt abdominal trauma. J Ayub Med
Coll Abbottabad 1997; 9:27-8.
Khan A. Stab wounds abdomen: An experience with 105
laparotomies. J Ayub Med Coll Abbottabad 1999;11:6-8.
Russel RCG. The spleen. In: Russel RCG, Williams NS,
Bulstrode JK eds. Bailey & Love short practice of surgery.
th ed. London: Arnold, 2004:1084-93
Ahmad I. Abdominal trauma. A prospective study. Pak J
Surg 1992;8:37-42.
Zafar A ,Chohan K, Faheem A, Zaheera M, Riaz A.
abdominal trauma in DHQ hospital Rawalpindi. Rawalpindi
Med J 1988;17:79-81.
Booth WCM, Cooper MJ. Surgical management of the
spleen. Surgery (quaterly edition) 1997;38:148-51.
David CS, Lyrely HK. Sabiston Surgery, 15th ed. WB
Saunders, Philadelphia 1997: 1187-1213.
Gosh S, Symes JM, Walsh TN. Splenic repair for trauma. Br
J Surg 1988; 75: 1139-40.
Targarona EM, Trias M. Laparoscopic treatment of splenic
injuries. Semin Laparosc Surg. 1996;3:44-9.
Arikan S, Yucel AF, Adas G, Culcu D, Gulen M, Arinc O.
Splenic trauma and treatments. Haseki Educationl and
Research Hospital Surgical department survey of the
feasibility of surgery for splenic trauma. Ulus Trauma Derg
;7:250-3.
Manohar NN, Rao RI, Irene W, Micael R, William MS. Nonoperative management versus early operation for blunt
splenic trauma in adults. Surg Gynecol Obstet1998; 166:252-
Powell M, Courcoulas A, Gardner M, Lynch J, Harbrecht
BG, Udekwu AO, et al. Management of blunt splenic trauma:
Significant differences between adults and children. Surgery
;122:654-60.
Wasvary H, Howells G, Villalba M, Madrazo B, Bendick P,
DeAngelis M, et al. Non-operative management of adult
blunt splenic trauma: a 15 year experience. Am Surg 1997;
; 694-9.
Goan YG, Huang MS, Lin JM. Non-operative management
for extensive hepatic and splenic injuries with significant
haemoperitoneum in adults. J Trauma.1998; 45: 360-4.
Carlin AM, Tyburski JG, Wilson RF, Steffes C. Factors
affecting the outcome of patients with splenic trauma. Am
Surg 2002;68:232-9.
Rathore AH. Penetrating abdominal injuries. Pakistan J
Surg1986;1:181-5.
Peter M. changing attitudes towards the management of blunt
splenic trauma in adults. Surg Gynecol & Obstet. 1988;166:
Bond SJ, Eichelberger MR, Gotschall CS, Sivit CJ, Randolph
JG. Non-operative management of blunt hepatic and splenic
injury in children. Ann Surg 1996;223:286-9.
Gaunt WT, McCarthy MC, Lambert CS, Anderson GL,
Barney LM, Dunn MM, et al. Traditional criteria for
observation of splenic trauma should be challenged. Am Surg
; 65: 689-91.
Barone JE, Burns G, Svehlak SA, Tucker JB, Bell T, Korwin
S, et al. Management of splenic trauma in patients older than
years. Southern Connecticut Regional Trauma Quality
Assurance Committee. J Trauma 1999; 46: 87-90.
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
