Splenic Injuries atAl-Kadhimiya Teaching Hospital

Abstract

Background: The spleen is the most common solid
organ injured in patients who had sustained abdominal
trauma. Such injuries to the spleen represent
approximately one quarter of all blunt injuries of the
abdominal viscera.
Due to its remarkable vasculature and its fragile
structure, splenic rupture is the most widespread cause
of intra-abdominal hemorrhage.
Objective: To assess the magnitude of splenic injury,
the management of splenic injury, and to evaluate the
postoperative complications.
Methods: A prospective study of 57 cases of splenic
injury was performed in Al-Kadhimiya Teaching
Hospital during the period between the 1st of October
2004 and the 1st of October 2006. Statistical analysis
was then performed to identify the causes, management
and postoperative complications. Splenic injuries were
graded into 5 grades.
Results: The highest incidence of splenic injury was
recorded in age group s31-40 year. Penetrating injury
was much more common than blunt trauma (73.68%
versus 26.31%).
Fifty patients (87 %) were diagnosed by exploratory
laparotomy, ultrasonography in 5 patients (8.77 %), CT
scan was positive in 2 patients (3.5 %). Associated
injuries were recorded in 41 patients 71.92%.
Pulmonary complications were the most frequent
complications (18 patients, 31.57 %).
Conclusion: Splenic injuries are common surgical
problems in Al-Kadhimiya Teaching Hospital. Still
there are many difficulties in establishing the diagnosis
of the splenic injury with shortage in the new diagnostic
modalities especially (CT -Scan, MR1 and even U/S
scan) in the emergency situations.
In spite of the dangerous post-operative complications
of splenectomy, it is still the most commonly performed
surgical procedure in cases of splenic injury