The management of blunt splenic injury with active bleeding: A review
| Autor: | Daryl Wall, Joel Diepenhorst, Michael Hatzifotis |
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| Rok vydání: | 2013 |
| Předmět: | |
| Zdroj: | Trauma. 15:222-227 |
| ISSN: | 1477-0350 1460-4086 |
| DOI: | 10.1177/1460408613489952 |
| Popis: | Blunt splenic injuries are a common management problem facing general surgeons. It has been suggested that management of blunt splenic injuries should take into account the presence of active bleeding and the Organ Injury Scale (OIS grade); where active bleeding is more significant with OIS grade IV and V injuries. This paper aims to review our management of blunt splenic injuries with active bleeding in the haemodynamically stable patient. The trauma databases of two tertiary referral centres in Queensland were reviewed for patients admitted with blunt abdominal injuries since 2006. The management of patients with splenic injury and active bleeding was reviewed. A total of 173 patients were admitted after 2006. Twenty-six of these patients had active bleeding and nine were treated conservatively. Four patients failed conservative management and required further intervention. Three patients with OIS grades IV or V were managed conservatively and failed this management requiring further intervention. Our results indicate that conservative management is not possible for OIS grades IV and V injuries. Furthermore, splenic artery embolisation augments the success of conservative management and reduces the need for splenectomy. These findings are consistent with the current literature suggesting that management of blunt splenic injury must take into consideration factors other than the Organ Injury Scale. |
| Databáze: | OpenAIRE |
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