Laparoscopic Treatment of Splenic Injury in Blunt Abdominal Trauma

Abstract

ABSTRACT Introduction Road traffic accidents are very common and pose a serious community problem in Libya. In 1998, the surgery unit at Zliten Teaching Hospital began using laparoscopy in the trauma unit for patients who were admitted to intensive care unit. A challenge for trauma surgeons is negative laparotomy which can result in increased complications for patients. Objective We reviewed medical records following the implementation of laparoscopic techniques in the trauma unit to determine the effectiveness of the treatment with patients who had been in road traffic accidents. Methods Review of medical records for patients admitted to Zliten General Hospital in Libya who had been involved in road traffic accidents was conducted. The records analyzed were from 1998 through 2012. Results One hundred and twenty-four patients underwent diagnostic and therapeutic laparoscopy over the 14 years time period, of which 76 patients had blunt abdominal trauma. The review of Zliten's trauma registry shows that 18 patients had splenic trauma and those patients who had splenic trauma. Out of the 18 patients who had blunt splenic trauma, three patients underwent laparoscopic splenectomy because it was not possible to preserve the spleen. One patient, aged 9 years, had an open laparotomy because the surgeons found that the spleen has avulsed completely and was lying at the left iliac fossa during diagnostic laparoscopy. Fourteen patients had small lacerations in the spleen. The spleen was not removed in these patients because profuse bleeding did not occur. No significant morbidity and no mortality were recorded. The hospital stay was between 2 and 5 days. Conclusion By using laparoscopy in trauma, we were able to preserve the spleen in the majority of our patients with splenic injuries who were hemodinamically stable. How to cite this article Yahya AI, Shwerief HE, Latifi R, Endaha NE, Algyead FO. Laparoscopic Treatment of Splenic Injury in Blunt Abdominal Trauma. J Trauma Critical Care Emerg Surg 2013;2(3):112-115.