19897

Conservative Versus Operative Management of Blunt Splenic Injuries

Article

Last updated: 03 Jan 2025

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Abstract

Background: The spleen is the most frequently injured organ in blunt abdominal trauma, mainly because of its highly vascularized parenchyma and its anatomic location. In the past the management of blunt splenic injuries was splenectomy, but high rate of operative complications caused paradigm shift from operative to non-operative management (NOM) in hemodynamically stable blunt abdominal trauma patients. Now, nonoperative management of hemodynamically stable patients with blunt splenic injuries is the standard of care and has been proven to be safe and successful in the acute setting. The advent of newer imaging techniques with high resolution CT scanners has enabled the clinicians to exactly diagnose the extent of intra-abdominal organ injury. Objective: This work aim to compare between operative and conservative management of splenic trauma. Methodology: Total numbers of patients in this study were 20 patients classified in two groups, the first group contained12 patients and the other group contained 8 patients. The First group was managed conservative and the second was managed operative with splenectomy and splenoraphy. The first group of patients consisted of 9 males (75%) and 3 female (25%). The second group of patients consisted of 6 males (75%) and 2 females (25%). Results: In this study, bunt splenic injury was found to be more common in males because of their risky and hard work. RTA and Falling from a height were found to be the most common causes of blunt abdominal injuries. According to CT, grade one and two of splenic injury are more common than other grades of splenic injury. As regard complication the operative management has more complication as postoperative wound infection and postoperative chest infection. So, NOM of splenic injury is the management of choice in haemodynamically stable patients. Conclusion: The nonoperative management is considered the ideal management for blunt splenic injuries due to less complication, less blood transfusion, less hospital stay and less mortality than operative management.

DOI

10.21608/ejhm.2018.19897

Keywords

Splenic, CT, Operative Management, conservative management

Authors

First Name

Abduh El-Said

Last Name

Mohammed

MiddleName

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Affiliation

Department of General Surgery, Faculty of Medicine, Al-Azhar University

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Orcid

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First Name

Mahmoud Abd El Hady

Last Name

Abd El Aziz

MiddleName

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Affiliation

Department of General Surgery, Faculty of Medicine, Al-Azhar University

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Orcid

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First Name

Ahmed Ramadan

Last Name

Abd El Rahim

MiddleName

-

Affiliation

Department of General Surgery, Faculty of Medicine, Al-Azhar University

Email

midobs9090@gmail.com

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Orcid

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Volume

73

Article Issue

10

Related Issue

4006

Issue Date

2018-10-01

Receive Date

2018-11-27

Publish Date

2018-10-01

Page Start

7,659

Page End

7,665

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_19897.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=19897

Order

6

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Conservative Versus Operative Management of Blunt Splenic Injuries

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Article

Created At

22 Jan 2023