Non-operative Management of Blunt Splenic Trauma

Ayesha Mehboob, Mazhar Iqbal, Kehkashan Anwar, Gul Mohammed, Malik Mussadiq, Sughra Parveen

Abstract

Objective

To Find the outcome of non-operative management of blunt splenic trauma in a tertiary care center.

Study design

Descriptive case series.

Place & Duration of study

Surgical Ward 3 Jinnah Postgraduate Medical Centre Karachi, from July 2016 to July 2019.

Methodology

All patients above 12 years of age, of both sexes, with isolated splenic injury due to blunt abdominal trauma, hemodynamically stable were included. On CT scan abdomen grading of splenic injury was done. Patients with polytrauma and those who needed resuscitation were excluded. Patients were monitored in ICU. If hemoglobin was less than 10 gm%, blood was transfused. If patients were hemodynamically unstable or delayed spleen rupture occurred, laparotomy was performed. Results were analyzed by SPSS version 24.

Results

There were 25 patients above 12 years of age with 23 (93%) male and 2 (7%) female. Ten (40%) patients were between 12-20 years of age, 14 between 21-40 years (56%) and     1 (4%). was 50 years Grade of splenic injury in 1 (4%) patient was 1, grade II in 3 (12%), grade III in 11 (44%), grade IV in 10 (40%) and grade V in 1 (4%) patient. Non-operative treatment of splenic trauma was successful in 24/25 (96%) patients. Splenic artery aneurysm was seen in 1 (4%) and delayed rupture of spleen occurred in 1 (4%) patient after 7 days.

Conclusion

Non-operative treatment up to grade IV splenic trauma was successful in 96%.

Key words

Splenic trauma, Spleen rupture, Splenic injury grade.