Splenic trauma - our experience at a level I Trauma Center

Saurabh, Gyan; Kumar, Subodh; Gupta, Amit; Mishra, Biplab; Sagar, Sushma; Singhal, Maneesh; Khan, Rafay; Misra, Mahesh C.

doi:10.5505/tjtes.2011.72621

Cited by 4 publications

(8 citation statements)

References 12 publications

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“…A critical appraisal yielded 21 studies utilized in this review (Tables 1, 2) [4–24]. Twenty retrospective cohorts [4–18, 20–24], one prospective cohort [19] assessed patients who received OM, NOM, or SAE due trauma [4–24]. Totally, 12,974 patients were included in the 21 selected studies.…”

Section: Methodsmentioning

confidence: 99%

“…A critical appraisal yielded 21 studies utilized in this review (Tables 1, 2) . Twenty retrospective cohorts [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][20][21][22][23][24], one prospective cohort [19] assessed patients who received OM, NOM, or SAE due trauma . Totally, 12,974 patients were included in the 21 selected studies.…”

Section: Study Selection and Assessment Of Quality Of Evidencementioning

confidence: 99%

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Post‐traumatic Splenic Injury Outcomes for Nonoperative and Operative Management: A Systematic Review

et al. 2021

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Background Splenectomies are widely performed, but there exists controversy regarding care for splenic injury patients. The purpose of this study is to provide a comprehensive review of the literature over the last 20 years for operative management (OM) versus nonoperative management (NOM) versus splenic artery embolization (SAE) for traumatic splenic injuries and associated outcomes. Methods A review of literature was performed following the PRISMA guidelines through a search of PubMed, EMBASE, Cochrane Library, JAMA Network, and SAGE journals from 2000 to 2020 regarding splenic injury in trauma patients and their management. Articles were then selected based on inclusion/exclusion criteria with GRADE criteria used on the included articles to assess quality. Results Twenty retrospective cohorts and one prospective cohort assessed patients who received OM versus NOM or SAE. Multiple studies indicated that NOM, in properly selected patients, provided better outcomes than its operative counterpart. Conclusion This review provides additional evidence to support the NOM of splenic injuries for hemodynamically stable patients with benign abdomens as it accounts for consistently shorter hospital length of stay, fewer complications, and lower mortality than OM. For hemodynamically unstable patients, management continues to be intervention with surgery. More studies are needed to further investigate outcomes of post‐splenectomy patients based on grade of injury, hemodynamic status, type of procedure (i.e., SAE), and failure of NOM in order to provide additional evidence and improve outcomes for this patient population.

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Section: Methodsmentioning

confidence: 99%

Section: Study Selection and Assessment Of Quality Of Evidencementioning

confidence: 99%

Post‐traumatic Splenic Injury Outcomes for Nonoperative and Operative Management: A Systematic Review

et al. 2021

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“…Subcapsular hematomas are seen in 37% of splenic injuries [1, 2]. Forty to seventy percent of these hematomas can be managed nonoperatively [1–3]. Most of the subcapsular hematomas are resolved and then reabsorbed spontaneously within 1-2 months, but some hematomas lead to delayed rupture.…”

Section: Discussionmentioning

confidence: 99%

“…Sometimes nonspecific abdominal pain and palpable mass may be the symptoms. During clinical examination, physicians rarely can palpate the splenic hematomas [1–3]. Radiologic differentiation of organized subcapsular hematoma from other malign or benign splenic masses usually cannot be possible [2].…”

Section: Discussionmentioning

confidence: 99%

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Splenic Hematoma Mimicking Angiosarcoma: A Case Report

Akküçük

Aydogan²,

Gökçe³

et al. 2012

Case Reports in Oncological Medicine

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Introduction. Splenic hematomas usually occur after blunt abdominal trauma. Most of the subcapsular hematomas will be resolved and reabsorbed spontaneously. However in rare cases, some of them organize and form calcified splenic masses. Angiosarcoma is an uncommon primary tumor of the spleen. Splenic angiosarcoma behaves extremely aggressive and has poor prognosis. Case Presentation. We report a forty-nine-year-old white male with organized splenic hematoma due to traffic accident mimicking splenic angiosarcoma. Conclusion. Both angiosarcoma and splenic organized hematoma have nonspecific symptoms and clinical findings. Because of the risk of hemorrhage and rupture, fine-needle biopsy should not be preferred. In case of splenic masses, excision and spleen-conserving surgery or total splenectomy should be performed.

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Ultrasound Diagnosis and Minimally Invasive Treatment of Posttraumatic Hematomas of the Spleen

Тюрюмина

Чижова

2019

Acta biomedica scientifica

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The work presents the analysis of ultrasound diagnostic of traumatic hematomas of the spleen in 12 patients after blunt abdominal trauma. Traumatic injuries of large (4 patients) and giant (5 patients) sizes prevailed. Only 3 patients had medium sized traumatic lesion. Ultrasound examination was performed for all patients as a primary procedure and for dynamic observation. We tracked evolution of traumatic spleen injuries and identified four stages of pathological process in case of aseptic development: the stage of “fresh hemorrhage”, the stage of “formed clot”, the stage of “aseptic lysis of the clot”, the stage of “connective tissue organization”. We determined the evidence of pyogenesis of spleen hematomas, identified the stage “bacterial lysis of the clot” and stage of “forming capsules”. We determined the indications and contraindications for the minimally invasive treatment of spleen hematoma. Percutaneous evacuation of the spleen hematoma was performed in all patients. In four cases of minimally invasive treatment was puncture. In one patient the treatment was completed with a single puncture, in 3 patients – with a double one. Drainage of spleen hematomas was performed in 8 patients. We analyzed the results of minimally invasive treatment of traumatic injuries of the spleen under ultrasound control. Minimally invasive treatment was successful in 11 patients. Only 1 patient was operated for post-traumatic aneurysm of the splenic artery due to the continuing bleeding into hematoma.

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Splenic trauma - our experience at a level I Trauma Center

Cited by 4 publications

References 12 publications

Post‐traumatic Splenic Injury Outcomes for Nonoperative and Operative Management: A Systematic Review

Post‐traumatic Splenic Injury Outcomes for Nonoperative and Operative Management: A Systematic Review

Splenic Hematoma Mimicking Angiosarcoma: A Case Report

Ultrasound Diagnosis and Minimally Invasive Treatment of Posttraumatic Hematomas of the Spleen

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