TITLE

Prospective Evaluation of Criteria for the Nonoperative Management of Blunt Splenic Trauma

AUTHOR(S)
Meguid, Ahmed A.; Bair, Holly A.; Howells, Greg A.; Bendick, Phillip J.; Kerr, Hugh H.; Villalba, Mario R.
PUB. DATE
March 2003
SOURCE
American Surgeon;Mar2003, Vol. 69 Issue 3, p238
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Recent reports have shown an increased mortality associated with the nonoperative management of blunt splenic injury. We have prospectively applied criteria developed from our previous 15-year experience for the nonoperative management (NOM) of blunt splenic injury. These criteria consist of 1) hemodynamic stability on admission or after initial resuscitation with up to two liters of crystalloid infusion, 2) no physical findings or any associated injuries necessitating laparotomy, and 3) a transfusion requirement attributable to the splenic injury of 2 units or less. From 1994 through 2000 a total of 99 patients presented with blunt splenic injury. Thirty-one patients (31%) underwent splenectomy secondary to hemodynamic instability. During the observation period eight of the 68 patients (12%) who initially met criteria for NOM developed hemodynamic instability and underwent splenectomy. All NOM failures occurred within 72 hours of admission. There was no mortality associated with splenic injury in the NOM (Group I) or in the group failing NOM (Group II), and no associated morbidities from the splenic injury were seen in either group. No significant differences were seen between Groups I and II in terms of age, gender, mechanism of injury, Injury Severity Score, admitting systolic blood pressure, admitting hemoglobin, transfusion requirements, intensive care unit length of stay, or total hospital length of stay (all P > 0.200). We conclude that established criteria for intervention and careful observation in an intensive care setting for at least 72 hours will minimize morbidity or mortality associated with blunt splenic injury in adults.
ACCESSION #
10544967

 

Related Articles

  • Retrohepatic inferior vena caval injury: Difficult but manageable situation. Darbari, Anshuman; Kumar, Ambrish; Tandon, Shekhar; Kumar, Shailendra // Indian Journal of Surgery;Oct2006, Vol. 68 Issue 5, p267 

    Inferior vena caval injuries remain a challenge for the skill, experience and diligence of a surgeon. Not only vascular surgeons, but all surgeons should be familiar with the principles of their treatment. We are reporting a patient of retrohepatic inferior vena caval injury due to blunt trauma....

  • Blunt Traumatic Pericardial Rupture: a Diagnostic Challenge. Rashid, Moheb A.; Lund, Jens T. // European Journal of Trauma;Dec2003, Vol. 29 Issue 6, p403 

    Traumatic pericardial rupture is a rare lesion associated with a high mortality rate, and its diagnosis poses challenges for the surgeon. Two patients are presented, in whom the diagnosis was not possible pre operatively, and discovered only during surgery for associated lesions. To the best of...

  • Severity of Cervical Spine Ligamentous Injury Correlates with Mechanism of Injury, Not with Severity of Blunt Head Trauma. Albrecht, Roxie M.; Malik, Salman; Kingsley, Darra D.; Hart, Blaine // American Surgeon;Mar2003, Vol. 69 Issue 3, p261 

    Clearance of the cervical spine (CS) in obtunded trauma patients in an intensive care unit is problematic. Patients with no osseous injuries have potential unstable extradural supportive soft tissue injury. Evaluation of the supporting structures involves dynamic fluoroscopy or MRI both of which...

  • Lamina Papyracea Breach: Brunt of Amateur Kabaddi. Belaldavar, Basavaraj; Tejaswini, J; Debnath, Paramita // Journal of the Scientific Society;Sep-Dec2018, Vol. 45 Issue 3, p136 

    The game of Kabaddi requires offensive and defensive skills that include consideration of the raid, taking cant and entry, tracing the path, footwork, attacking tactics, and returning back which makes the players prone to many types of sports-related injuries. It being a contact game many body...

  • Pharyngeal perforation caused by blunt trauma to the neck. Hagr, Abdulrahman; Kamal, Dhafer; Tabah, Roger // Canadian Journal of Surgery;Feb2003, Vol. 46 Issue 1, p57 

    Discusses the case of a male patient with pharyngeal perforation caused by blunt cervical trauma. Vital signs of the patient; Findings of computed tomography; Nasotracheal intubation of the patient.

  • ABDOMINAL INJURIES AND DANGEROUS FRACTURES. Perdue, Patricia // RN;Jul81, Vol. 44 Issue 7, p34 

    Provides information on the assessment of abdominal injuries and dangerous fractures. Information on how to check for nerve damage; Signs of blunt trauma; Methods of diagnosing internal injuries due to abdominal trauma; Internal signs of fractures.

  • Pancreatic injuries from blunt trauma. Craig, Mark H.; Talton, David S. // American Surgeon;Feb1995, Vol. 61 Issue 2, p125 

    Reviews cases of pancreatic injuries from blunt trauma. Compression of the pancreas against the vertebral bodies as the classic description of the mechanism of blunt trauma to the pancreas; Management of blunt injuries by localized resection and/or drainage; Absence of relation between blunt...

  • Bruises. Chen, Joanne; Reilly, Kimberly // Glamour;Nov95, Vol. 93 Issue 11, p76 

    Presents recommendations on treating bruises. Causes; Use of ice; Changes in the color of a bruise after several days; Variations in the healing process; Use of cosmetics to hide bruises; Bruises as a possible indication of more serious diseases. INSET: If a bruise doesn't go away..

  • Eye injuries caused by elasticated straps. Gray, R.H.; Menage, M.J.; Cook, S.D.; Harcourt, J. // British Medical Journal (Clinical Research Edition);4/16/1988, Vol. 296 Issue 6629, p1097 

    Examines the effect of blunt trauma to the eyes. Consideration of the dangers of elasticated straps with hooks; Suggestion of redesigning hooks used in luggage; Enumeration of ocular trauma suffered.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics