A STUDY OF PATIENTS PRESENTING WITH BLUNT ABDOMINAL INJURY WITH SPLENIC TRAUMAAND THEIR OUTCOME.

Author:

Mali Abhilash1,Bijwe Varsha2,Bodhankar Yashodhan3,Shete Bharat3

Affiliation:

1. Junior Resident In Department of Surgery, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati.

2. Professor In Department of Surgery, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati.

3. Assistant Professor In Department of Surgery, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati.

Abstract

INTRODUCTION - Spleen injuries are among the most frequent trauma-related injuries. At present, they are classied according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology with a multidisciplinary team. Thus, the study to determine the presentation of a patient and further its investigation management and outcome is necessary. OBJECTIVE: To study all the cases (investigation and outcome) of blunt abdominal trauma with splenic laceration with its incidence , mode of presentation, grade, management and factors responsible for morbidity and mortality. MATERIALAND METHODS:Astudy was conducted in our tertiary care hospital on 22 patients presented with blunt abdominal trauma with splenic injury in emergency department during July 2019 to June 2021. RESULTS: In our retrospective study , all the patients underwent primary radiological and pathological investigation with 36% having associated limb injuries (fractures);4.5% with ckd , 9% with thoracic injury, 40% amongst 20-40 age group , 86% being male, 59.5% resulted from RTA, 31.5 % resulted from fall from height,0% with assault, 4.5% along with head injury, 9% with associated rib fracture,0% patient with free gas under diaphragm ; 9% with grade 1, 22% with grade 2, 31.5% grade 3 , 13.5% grade 4, 22%grade 5 splenic injuries. 91% patients underwent splenectomy and were given vaccination 15 days post operatively against capsulated organisms.9% patients were managed conservatively. Patients were followed up for 6 months postoperatively with 4.5% mortality rate. CONCLUSION: Splenic injury is most common solid organ injury in blunt abdominal trauma in 20- 40 years age group majority male and results maximally by RTA; associated with limb fractures commonly with liver as associated solid organ injured. Aggressive resuscitation and emergency laparotomy (splenectomy) yields excellent outcome

Publisher

World Wide Journals

Reference9 articles.

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2. Alamri Y, Moon D, Yen DA, Wakeman C, Eglinton T, Frizelle F, et al. Ten-year experience of splenic trauma in New Zealand: The rise of non-operative management. NZ Med J 2017;130:11-8.

3. Cathey KL, Brady WJ Jr., Butler K, Blow O, Cephas GA, Young JS, et al. Blunt splenic trauma: Characteristics of patients requiring urgent laparotomy. Am Surg 1998;64:450-

4. Sözüer EM, Ok E, Banli O, Ince O, Kekeç Z. Traumatic splenic injuries. Ulus Travma Derg 2001;7:17-21.

5. Shweiki E, Klena J, Wood GC, Indeck M. Assessing the true risk of abdominal solid organ injury in hospitalized rib fracture patients. J Trauma 2001;50:684-8.

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