Blunt isolated pancreatic trauma is uncommon,accounting for 1%-4% of high impact abdominal injuries.In addition,its diagnosis can be difficult;physical signs may be poor and laboratory findings nonspecific,resulting i...Blunt isolated pancreatic trauma is uncommon,accounting for 1%-4% of high impact abdominal injuries.In addition,its diagnosis can be difficult;physical signs may be poor and laboratory findings nonspecific,resulting in delayed treatment.Preserving the spleen during distal pancreatectomy (DP) is controversial.One of the spleen's functions regards immunity;complications following splenectomy include leukocytosis,thrombocytosis,overwhelming post splenectomy sepsis and some degree of immunodeficiency.This is why many authors favor its preservation.We describe a case of a young man with an isolated pancreatic trauma due to a blunt abdominal trauma with a delayed presentation who was treated with spleen-preserving DP and we discuss the value of this procedure with reference to the literature.展开更多
The purpose of this case report is to discuss the different treatment options available in splenic trauma patients by following the story of Mr. H. I will focus particularly on the role of splenic arterial embolisatio...The purpose of this case report is to discuss the different treatment options available in splenic trauma patients by following the story of Mr. H. I will focus particularly on the role of splenic arterial embolisation (SAE)—an interventional radiological procedure—and how it weighs up against its surgical counterparts. In order to give a balanced view this case report includes a literature review around splenic artery embolisation. This report concludes that when managing splenic trauma, interventional radiology (IR) is a useful tool particularly when used in conjunction with surgery. The future of this field needs to allow SAE to become a stand-alone therapy. Furthermore, research needs to investigate which cohorts of patients are best suited to which intervention such that we can capitalise on the advantages of each intervention for the benefit of all.展开更多
A 41-year-old woman with blunt abdominal trauma due to a motor vehicle accident presented to our emergency department. The patient had a history of a giant hepatic cavernous hemangioma. Emergency exploratory laparotom...A 41-year-old woman with blunt abdominal trauma due to a motor vehicle accident presented to our emergency department. The patient had a history of a giant hepatic cavernous hemangioma. Emergency exploratory laparotomy was performed for suspected intra-abdominal bleeding with abdominal compartment syndrome, and more than 4 liters of blood and blood clots were removed. An active bleeding laceration （5 cm） of a hepatic cavernous hemangioma was detected in segment III of the liver. The bleeding was controlled by sutures, Teflon patches and tamponade. The abdomen was closed temporarily using the vacuum-assisted method. Because of the presence of persistent fresh blood through abdominal drainage at a rate of 〉1 L/h, splenectomy was performed to control the bleeding again by sutures and Teflon patches. Finally, the abdomen was closed using a biologic mesh. The patient was discharged home 30 days after trauma. Bleeding of trauma-caused hepatic hemangioma is rare, but splenic injury due to blunt abdominal trauma is common. An in-depth investigation is necessary to avoid second intervention.展开更多
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. I...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.展开更多
文摘Blunt isolated pancreatic trauma is uncommon,accounting for 1%-4% of high impact abdominal injuries.In addition,its diagnosis can be difficult;physical signs may be poor and laboratory findings nonspecific,resulting in delayed treatment.Preserving the spleen during distal pancreatectomy (DP) is controversial.One of the spleen's functions regards immunity;complications following splenectomy include leukocytosis,thrombocytosis,overwhelming post splenectomy sepsis and some degree of immunodeficiency.This is why many authors favor its preservation.We describe a case of a young man with an isolated pancreatic trauma due to a blunt abdominal trauma with a delayed presentation who was treated with spleen-preserving DP and we discuss the value of this procedure with reference to the literature.
文摘The purpose of this case report is to discuss the different treatment options available in splenic trauma patients by following the story of Mr. H. I will focus particularly on the role of splenic arterial embolisation (SAE)—an interventional radiological procedure—and how it weighs up against its surgical counterparts. In order to give a balanced view this case report includes a literature review around splenic artery embolisation. This report concludes that when managing splenic trauma, interventional radiology (IR) is a useful tool particularly when used in conjunction with surgery. The future of this field needs to allow SAE to become a stand-alone therapy. Furthermore, research needs to investigate which cohorts of patients are best suited to which intervention such that we can capitalise on the advantages of each intervention for the benefit of all.
文摘A 41-year-old woman with blunt abdominal trauma due to a motor vehicle accident presented to our emergency department. The patient had a history of a giant hepatic cavernous hemangioma. Emergency exploratory laparotomy was performed for suspected intra-abdominal bleeding with abdominal compartment syndrome, and more than 4 liters of blood and blood clots were removed. An active bleeding laceration （5 cm） of a hepatic cavernous hemangioma was detected in segment III of the liver. The bleeding was controlled by sutures, Teflon patches and tamponade. The abdomen was closed temporarily using the vacuum-assisted method. Because of the presence of persistent fresh blood through abdominal drainage at a rate of 〉1 L/h, splenectomy was performed to control the bleeding again by sutures and Teflon patches. Finally, the abdomen was closed using a biologic mesh. The patient was discharged home 30 days after trauma. Bleeding of trauma-caused hepatic hemangioma is rare, but splenic injury due to blunt abdominal trauma is common. An in-depth investigation is necessary to avoid second intervention.
文摘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.
