Abstract
Objectives
- To study the various causes of splenic trauma
- To study the various clinical features of splenic trauma
- To study the methods of management of splenic trauma
Methods: A total of 52 cases admitted to various surgical wards in a tertiary care centre were studied from July 2015 to October 2017. Patients, both male and female, between the ages of 12-70 years with abdominal trauma were included in the study. These patients were analysed based on clinical history, signs and symptoms and treatment given in the way of a prospective observational study.
Results: Out of the 52 cases studied, the most common cause of splenic injury was road traffic accident (34%) followed by fall from height (25%). Out of 52 patients studied, 7 died and 45 recovered. The majority of patient who recovered were stable at presentation (64%) while in the subset who died majority were unstable (85%). On examination, 84% of the patients who recovered had abdominal signs on presentation with 16% having non abdominal signs. Out of those who died, 42.9% had non abdominal signs at presentation on examination. The most common grade of injury was grade 3 (44%) followed by grade 2 (24%) and grade 4 (22%). 25 of these patients had no co-existing injury. In those with other injuries, the most common was fractured ribs (11.5%). The most common mode of management was splenectomy (69%).
Conclusion: Our case series shows that the most common cause of splenic injury is road traffic accident followed by fall from height. Most cases are clinically stable at presentation and complain of pain in abdomen and vomiting. The most common associated injury is fractured ribs. On examination, most patients present with guarding and rigidity, with more severe cases also having signs of shock. Grade III was the most common grade of injury. The most common modality of treatment was splenectomy.
Keywords: Splenic trauma, causes, clinical features, management.
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Corresponding Author
Dr Ali Zaid Anwar
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.15
