A profile of splenic trauma cases managed at a tertiary care center

Abstract

Context: Missed splenic injury is the most common cause of preventable death after abdominal trauma. As clinical presentation varies widely awareness of spectrum of presentations and their relative importance is vital for diagnosing and managing splenic injuries successfully. Aim: To study various clinical presentations, modes of management and analyse outcomes of splenic trauma. Setting and design: Retrospective observational study conducted at a tertiary care teaching hospital. Methods and Material: 154 cases of adult splenic trauma presented to our teaching hospital between 2006 and 2014 diagnosed by FAST or CT scan or per operatively were enrolled retrospectively. Hemodynamically stable patients with grade 1 and 2 injuries with no other injuries necessitating laparotomy were chosen for NOM. Rest underwent splenectomy. Statistical Analysis Used: Descriptive statistics were used for analysis of data and results were expressed as percentages. Results: Highest number (44.15%) of victims were aged between 31-40 years. RTAs constituted 69.48%. 13.63% patients were asymptomatic initially. 58.94% were Grade-III injuries. Fracture ribs (90.25%) and hemo or pneumothorax (72.72%) were the most common associations. Number of cases selected for NOM were only 13.64%. Conclusions: Grade I and II isolated splenic injuries can be safely managed by NOM however under close monitoring. Absence of abdominal signs and symptoms do not exclude splenic trauma.

Keywords

• Splenic trauma
• associated injuries
• NOM