Incidence and Management of Splenic Injury in Abdominal Trauma

Summary A prospective study of 109 patients with splenic injury due to abdominal trauma was collected from the causalty department of two centers, teaching hospital, Saddam Medical College and a AI-Yarmouk teaching hospital in the period from January 1992-January 1997. The aim of our study is to evaluate the Incidence, causes and management of injured spleen with abdominal trauma taking into account that the spleen is the most common solid organ injured with blunt abdominal trauma (1), and major cause of this trauma Is auto-mobile accident, while In penetrating trauma (stab, shotgun) the incidence of splenic injury with associated injury come next in incidence.60 patients out of 109 patient have splenic injury due to blunt trauma, while (49) patients got splenic injury from penetrating trauma. Since our policy is to explore all penetrating trauma the problem of early recognition arise In patients with blunt trauma whom need frequent physical examinations and close observation to detect signs of hypovolemia, because most trauma come to casualty at night without availability of aiding diagnostic tools like U/S, or precise lab service splenectomy was undertaken for 104 patients and successful splenoraphy was done for 5 patients. In our study there is no place for conservative treatment because there is no sound clinical or Investigation to depend on it to know with insurance about degree of splenic laceration and whether this laceration is isolated or associated with other intra-abdominal organic injury. Post splenectomy complication were mostly due to pulmonary and secondary wound infection