A study on management of splenic injuries in abdominal trauma
DOI:
https://doi.org/10.7439/ijbar.v9i6.4806Keywords:
Grade of injury, Hemodynamic stability, Operative managemen, NOM (Non - operative management)Abstract
Aim: To study about the different grades and their clinical presentations of splenic injury and various management options of the same and their outcome on follow-up for a period of 3 months.
Background and Objectives: Spleen being a most common solid organ injured in abdominal trauma. Successful management of splenic injury consists of diagnosis and prompt management of potentially life threatening hemorrhage. The present study is conducted to highlight the important clinical manifestations, to identify different grades, to identify proper investigation modalities for rapid and accurate diagnosis and to study criteria to select best management option.
Methods: 30 consecutive cases of splenic injury at Bapuji hospital and Chigateri hospital, Davangere, Karnataka, India, were studied with regard to etiologies, clinical manifestations, best diagnostic modality available, different grades and their behavior, management options best available in our setup, outcome and complications. Patients with associated head injury and with age less than 15 years were excluded. Results: Predominantly male patients within age group of 25-45 years were found to be more prone for traumatic splenic injury, RTA being most common cause. Pain abdomen was most common symptom and tenderness was most common sign. CT-Scan abdomen was most useful and accurate in diagnosing the injury. Grade II splenic injury was most common grade and Grade V was most fatal. Operative management was the most common modality of management. The mortality rate was 3.
Conclusion: Even with so many advances in management of splenic injury, hemodynamic instability, higher grades of injury and lack of facilities, expertise and low socioeconomic status makes NOM unsuccessful. Operative management is still most commonly used modality to manage splenic injuries.
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