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Year : 2018  |  Volume : 11  |  Issue : 3  |  Page : 112-115

The management of blunt splenic injury in adults: The trauma centre experience in Dubai

Department of General Surgery, Rashid Hospital, Dubai, UAE

Correspondence Address:
Ali Salem
Department of General Surgery, Rashid Hospital, Dubai
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/HMJ.HMJ_46_18

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Introduction: The spleen is the most frequently injured solid organ during blunt abdominal trauma. The treatment strategy for managing splenic insults came under review as doctors were increasingly concerned about post-splenectomy sepsis. Nonoperative management (NOM) of blunt splenic injuries (BSIs) became the standard of care for most of the cases where patients are haemodynamically stable, irrespective of injury grade. Methodology: This is a retrospective study where all adult patients with blunt abdominal injuries treated at level-1 trauma centre in Dubai, between January 2011 and October 2013, were reviewed. Data regarding demographics, pre-operative management, intraoperative findings, blood transfusions requirements and length of hospital stay were collected from patients' files. SPSS (version 20, IBM) was used for data analysis. Results: During the study, 153 patients were enrolled. Nearly 82% of patients with splenic injury were between 13 and 44 years of age. Only 12 patients had an isolated splenic injury. Of 153 patients, 106 were managed conservatively; only 6/106 failed the conservative treatment and got operated. Of 6 patients, 2 were operated due to bowel perforation and the rest 4 patients underwent splenectomy due to hemodynamic instability and drop in haemoglobin. Among the living group, 25/30 patients with Grade I injury and 45/50 patients with Grade II injury were managed conservatively. Conclusion: NOM of BSI was successful in 62.1% in our study which is consistent with other studies. Careful selection of patient and resource availability should be taken into consideration while adopting NOM approach.

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