Study of the spectrum of splenic trauma in tertiary care centre in GMC Jammu
DOI:
https://doi.org/10.18203/2349-2902.isj20223160Keywords:
Splenic trauma, FAST, CT scan, NOM, SplenectomyAbstract
Background: the aim of the study was to study the clinical presentations, modes of management and outcome in a patient with splenic trauma. Setting and design of study retrospective observational study conducted in a tertiary care hospital in GMC Jammu.
Methods: The study was done in the department of general surgery in a tertiary care centre that has round the clock availability of all radiological investigations. A total 50 cases of splenic trauma diagnosed by focussed abdominal sonography in trauma (FAST) or CT scan or per operatively were enrolled in the study.
Results: Maximum number (36%) of patients were aged between 31-40 years of age. Most of the patients (92%) presented with blunt abdominal trauma. RTA (40%) and fall (40%) were the common causes of blunt abdominal trauma. Maximum patients (36%) had grade III splenic injury.30% of the patients managed by NOM while 70% underwent splenectomy.
Conclusions: Patients with splenic injury (grade I-grade III) can be managed by NOM without increased morbidity and mortality through proper monitoring.
References
Townsend C. Sabiston’s textbook of surgery, In ch. 161st South Asia edition, section III. 2007;435-6.
Nicholas JM, Rix EP, Easley KA. Changing patterns in the management of penetrating abdominal trauma: The more things change, the more they stay same. J Trauma. 2003;55:1095-1108.
Beuran M, Negoi I, Paun S, Runcanu A, Venter D, Iordache F. Selective nonoperative management of solid abdominal visceral lesions. Chirurgia (Bucur). 2010;105:317-26.
Haan J, Scott J, Boyd-Kranis RL, Ho S, Kramer M, Scalea TM. Admission angiography for blunt splenic injury: Advantages and pitfalls. J Trauma. 2001;51:1161-5.
Haan JM, Biffl W, Knudson MM,Davis KA, Oka T, Majercik S. Western Trauma Association Multi-Instituional Trials Committee. Spleinc embolization revisited: a multicenter review. J Trauma. 2004;56:542-7.
Kasula J, Yerroju K, Masood SV, Pindicura CV, Quadri SS. A profile of splenic trauma cases managed at a tertiary care center. J NTR Univ Health Sci. 2016;5:7-12.
Ahmed H, Pegu N, Rajkhowa K, Baishya RK, Hiquemat N. Splenic injury: a clinical study and management in a tertiary care hospital. Int Surg J. 2015;2:652-9.
Agbakwuru EA, Akinkuolie AA, Sowande OA, Adisa OA, Alatise OI,Onakpoya UU et al. Splenic injuries in a semi urban hospital in Nigeria. East Cen Afr J Surg 2008;13:95-100.
Bansal A, Bansal AK, Bansal V, Kumar A. Experience with splenic trauma in Jeevan Jyoti Hospital, Allahabad, Uttar Pradesh, India. IJDR. 20155:5510-13.
Goins WA, Rodriguez A, Joshi M, Jacobs D. Intrabdominal abscess after blunt abdominal trauma. Ann Surg. 1990;212:60-5.
Khanna R, Khanna S, Singh P, Khanna P, Khanna AK. Spectrum of blunt abdominal trauma in Varanasi. Quaterly J Surg Sci. 1999;35(1):25-8.
Chalya PL, Mabula JB, Giiti G, Chandika AB, Dass RM, McHembe MD et al. Splenic injuries at bugando medical centre in nortwestern Tanzania: A tertiary hospital experience. BMS Res Notes. 2012;5:59.
Tan KK, Chiu MT, Vijayan A. Management of isolated splenic injuries after Blunt Trauma: An institution’s experience over 6 years. Med J Malaysia. 2010;65:304-6.
Mclellan BA, Hanna SS, Monoya DA. Analysis of peritoneal parameters in blunt abdominal trauma. J Trauma. 1985;25:393-99.
Allen RB, Curry GJ. Abdominal trauma: a study of 297 consecutive cases. Am J Surg. 1957;93:398-404.
Finelli DA, Duncan RE, Fallon WF. Current Management of Splenic Injury. AHC Media. 2008.
