Title

Penetrating Splenic trauma :

Can we save splenic function
without surgery ???

Presented by

Dr Mohammad Abed Abbas

HMO
Department of Casualty and Emergency
Dhaka Medical College Hospital.
 Authors
Roy spikerman
Micheal paul johan Teuben
Fatima Hoosain
Liezel Phyllis Taylor
Timothy craig
Taco johan
Brian Warren
Luke Leenen

Source

World journal of emergency Surgery (2017)

12:33

Place of study

Dual centre study in two level – one trauma centre

Tygerberg Hospital in (Capetown)

Inkosi Albert Luthuli Central Hospital (Durban)

Period of study
September 1, 2010 to September 1, 2014 in Tyberg Hospital

April 1, 2007 to April 1,2014 Inkosi Albert Luthuli Central Hospital

(Durban)

Study design
 Obseervational , retrospective cohort study

Objective of study
Investigate the outcome of selective NOM for penetrating splenic
injuries

Method
It was an observation retrospective cohort study. A dual center study
was performed in two level –one traum centres. All identified patients
treated for Penetrating Splenic Injury were identified. Patients were
grouped based on the treatment they received. Group one consisted of
splenectomized patients ,, second group included patients treated by
spleen preserving surgical intervention and group three included those
patients who are treated by NOM.
Computed tomography (CT scan) reports were documented and used
for this study. All patients who were hemodynamically stable enough
were preoperatively scanned by CT.

Sales

Splenectomy
Spleen preserving surgery
NOM
 We excluded patients

Inclusion Criteria

1. All patients with penetrating splenic injuries

2. diagnosed by preoperative CT scan and
3.hemodynamically stable
Gcs 15

4. Both Gun shot and stab injuries to abdomen

during 4 year period at Tygerberg Hospital and a 6 year period at the
Inkosi Albert central Hospital were included which was 118 in total.

Eclusion Criteria

1.Patients who died in the emergency department before the

diagnostic work up was completed
2.Decreased level of consciousness( GCS <15), spinal cord injuries, signs
of peritonitis, blood in nasogastric tube and blood on rectal
examination.
Results