Management of Spleen Injury: A One Year Experience from a Tertiary Care Hospital in Nepal

A* Joshi

Abstract


Introduction: The management of spleen injury has progressed from the era of splenectomy to the era of splenic preservation. This study aims to determine the management approach and outcome following spleen injury in a tertiary care hospital.


Method: A retrospective observational study was conducted from June 2015 to May 2016 from hospital records in Department of surgery at National Academy of Medical Sciences (NAMS). The American Association for the Surgery of Trauma Organ Injury Scale (OIS) was used for grading splenic injury. The analysis was done for operative rate, mortality, hospital length of stay and ICU length
of stay. Different modalities of treatment and the treatment outcomes were evaluated.


Result: There were total of 15 cases of spleen injury. The most common mode of injury was fall from height (66.6%) followed by road traffic accidents (20%) and stab injury (2%). Sixty percent of the cases underwent operative management out of which 55.5% cases had splenectomy, 22.2 % cases had splenic repair and 22.2% had repair of associated liver injury. There were 13.3% mortality and 86% recovery without residual morbidity.


Conclusion: Most of the cases with spleen injury were managed with favorable outcome. The careful patient selection for non operative management will result in higher splenic salvage.


Key words: Injury, Management, Outcome, Spleen

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