Etiology and management of splenic injuries: The experience at Federal Teaching Hospital, Gombe, Northeast Nigeria

Abstract

Objective: To appraise the current management of splenic trauma with the available resources in our environment and re-emphasizing the role of a sound clinical judgment and early intervention. Methodology: This is a prospective cross-sectional study in which patients that sustained splenic injuries were resuscitated and optimized for laparotomy. Broad spectrum antibiotics and generous analgesia were given. Laparotomy was carried out in all patients and treatment was given according to the grade of injury sustained. Other systemic injuries were co-managed with other subspecialties. Results: Patients in the study were aged 7–52 years (male: female = 3.4:1). The modal age group was 11–20 years. All patients were managed operatively. The majority (51.5%) of splenic trauma in our study were due to vehicular accidents. There was no statistical association between sonographic and intraoperative findings (P = 0.218). Splenectomy was the most common procedure carried out. Complications encountered include surgical site infection (9, 27.3%), respiratory tract infection (6, 18.2%), and deep vein thrombosis (1, 3.0%). The duration of hospital stay for patients was 9–26 days (mean = 12.69 ± 6.30 days). Conclusion: The management of splenic injuries has evolved over the years. The role of a sound clinical judgment is crucial to a successful management outcome, especially in the third world countries.

Keywords

• Management outcome
• spleen
• trauma