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Cirujano general

versão impressa ISSN 1405-0099

Resumo

PADRON ARREDONDO, Guillermo. Splenectomies for abdominal trauma in a Second Level General Hospital. Analysis of 5 years. Cir. gen [online]. 2019, vol.41, n.2, pp.79-85.  Epub 09-Out-2020. ISSN 1405-0099.

Introduction:

Approximately a quarter of the closed abdominal traumas present spleen injury and a high index of clinical suspicion is required along with the help of the imaging studies to be able to make the decision to operate, because when these patients are carefully chosen and it is decided not to operate, this is related to a low morbidity and mortality rate.

Material and method:

The demographic variables were obtained: age and sex; etiology; Laboratory tests: group and Rh, Hemoglobin, arterial blood gases; Cabinet studies: (US, TAC), admission to ICU, intrahospital stay and morbidity.

Results:

During the study period, twelve splenectomies were performed for open abdominal trauma two and closed nine; with thoraco-abdominal injury five Packaging four, eight without morbidities.

Discussion:

Is establish that the risk factors in a patient who does not operate are age > 55 years, degree of injury and hemoperitoneum volume (moderate 250 to 500 ml and severe > 500 ml), concomitant lesions to other solid organs and vascular anomalies. When there is hemodynamic instability which they define as blood pressure < 90 mmHg and heart rate > 130 beats per minute, it is an indication to operate immediately.

Conclusions:

In our hospital all cases were managed with total splenectomy because they presented additional hepatic, renal, intestinal, and/or diaphragmatic damage that justified the surgical intervention and we did not consider the preservation of the spleen.

Palavras-chave : Abdominal trauma; spleen trauma; splenectomy; conservative treatment; Non conservative management.

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