The Incidence of Splenic Injury Following Blunt Abdominal Trauma (BAT), Sultan Qaboos University Hospital Experience

The aim of the study was to review traumatic splenic injury following blunt abdominal trauma (BAT), during the period from January 2009 to January 2015 at SQUH. The data for this study was retrospectively collected. It included 768 patients admitted to SQUH general surgery department following BAT. 43 patients with splenic injury were identified (34 males, 9 females). The mean age of patients with splenic injury was 36.0 years (34.4 years for males, 42.1 years for females). The most common mechanism of injury was motor vehicle collision (90.7%). Grade I, II are the most common grades of splenic injury. Non-Omani patients accounted for (51.2%) and most of them were pedestrians at the time of trauma. Ribs fracture is the most common injury associated with splenic injury. 36 (83.7%) patients were managed conservatively and 7 (16.3%) patients were splenectomized. Angioembolization was done for 11 (30.6%) patients. Despite the small population of Oman, high incidence of motor vehicle collision (MVC) increases the incidence of splenic injury among young age group.

Traumatic Splenic Injuries in Khartoum, Sudan

Background: Spleen injuries are most commonly associated with blunt abdominal trauma and represent a potentially life-threatening condition. Objectives: To study the pattern of splenic injuries of the patient, management instituted and its outcome at Khartoum. Patients and Methods: This is a prospective, analytic and hospital-based multicenteric study, conducted at the three main Teaching hospitals at Khartoum. The study was carried over a period from April 2012 to February 2013. It includes all patients, diagnosed as traumatic splenic injury. Excluded were patients with history of splenic disease, iatrogenic injury or spontaneous rupture. Results: The study included 47 patients: their mean age was 26.4 years (SD ± 14.5). Most of them 41 (87.2%) were in the first four decades of life. Males were predominant 41 (87.2%), with a male to female ratio of 6.8:1. The majority of our patients had blunt abdominal trauma 39 (83%), of whom, road traffic accident accounted for 51.1% and none reported cases of gunshot. Isolated splenic injury was found in 23 (48.9%), and Haemodynamic stability was seen in 27 (57.4%) on presentation. The initial haemoglobin assessment revealed <9 gram/dl in 53.2%. CT scan was performed to 24 (51.1%), of whom 66 patients were Grade I and II and none of our patients were diagnosed as Grade V. Blood transfusion was required in 42 (89.4%). Operative treatment was adopted in 66% (61.7% total splenectomy and 4.3% splenorrhaphy), while selective non-operative management was successful in 16 (34%) of the patients. Higher intra-operative grade of splenic injury was found to be significantly associated with blunt abdominal trauma, haemodynamic instability and associated intra-abdominal injuries. 44 patients (93.6%) were discharged home in a general good condition. The morbidity and mortality were seen in 8.5% and 6.4% respectively. Conclusion: Splenic injuries usually follow blunt abdominal trauma, particularly after road traffic accidents. It is common during the first four decades of life with males being frequently affected. The great success rate of adopting selective non-operative management is worthwhile.

钝性脾损伤的CT研究

目的：提高钝性脾损伤的ＣＴ诊断正确性及探讨ＣＴ分级的价值。材料和方法：回顾性分析３２例钝性脾损伤的ＣＴ表现，其中１９例保守治疗成功，１３例行手术治疗。根据ＣＴ表现分为４级。Ｉ级：局限性包膜破裂或小的包膜下血肿；Ⅱ级：小的外周撕裂或实质内血肿小于３厘米；Ⅲ级：撕裂延伸至脾门或实质内血肿大于３厘米；Ⅳ级：广泛性脾或血管撕裂。结果：ＣＴ显示包膜下血肿９例，实质内血肿１７例，脾撕裂１９例，脾周血肿１８例，腹腔积血２１例。１９例保守治疗中，Ⅰ级８例，Ⅱ级７例；Ⅲ级４例。１３例手术治疗中，Ⅰ级１例，Ⅱ级２例，Ⅲ级７例，Ⅳ级３例。结论：ＣＴ是诊断脾损伤的可靠方法，且ＣＴ的分级对临床处治有帮助。

脾破裂行非手术治疗的体会

目的 :探讨和总结非手术疗法在腹部闭合性损伤脾破裂中的经验和体会。方法 :选出本组 2 6例腹部闭合性损伤脾破裂病人 ,予以非手术的一系列治疗、监测。结果 :2 6例中 ,非手术治疗成功 2 0例 ,中转手术 6例 ;成功的 2 0例出院随访 ,疗效良好。结论 :非手术治疗是腹部闭合性损伤脾破裂中保脾的重要方法 。