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J Korean Soc Emerg Med > Volume 1(1); 1990 > Article
Journal of The Korean Society of Emergency Medicine 1990;1(1): 130-137.
Clinical Analysis of Splenic Injury
Dae Yune Jeong, Joo Seop Kim, Soo Tong Pai
ABSTRACT
Recently the spleens important role in immunity and the danger of postsplenectomy sepsis are established. Consequently, splenic preservation rather than total removal has been changed as the preferred treatment in the splenic injury. Moreover the concepts of non operative management are now evolving. This report is a retrospective analysis in 31 cases of the splenic injury during the past 3 years and 7 months. All cases sustained blunt injuries. Traffic accidents were the most common cause. 24 patients (77. 4 %) underwent urgent operations. Of these, 11 (45. 9% ) were treated by splenorrha- phy or partial splenectomy and 13 (54. 1%) were treated by splenectomy. 7 patients (22. 6%) considered for non operative management were less than 18year old, pregnant, alert, hemodynamically stable with evidence of isolated splenic injury in the ultrasund or computed tomography. Postoperative complications developed in 14 cases (58.3%). Postoperative mortality were in 3 cases (12.5'%) mainly due to fatal cerebral injuries. No complications, deaths and delayed operations in the non operative groups. Non operative treatment can be accomplished safely and successfully if adequte criteria are selected.
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