Surgery Today

, Volume 29, Issue 1, pp 23–27 | Cite as

Protective procedures followign splenic rupture

  • Ümit Topaloĝlu
  • Ali Yilmazcan
  • Selçuk Ünalmişer
Original Articles


The aim of the present study was to improve spleen-preserving procedures in patients undergoing laparotomy following abdominal trauma. Of a total 288 patients who underwent laparotomy for abdominal trauma in the Fourth General Surgical Department of Hardarpaş a Teaching Hospital between 1989 and 1996, 94 patients with splenic injuries were retrospectively analyzed. The mean age of these 94 patients, 69% whom were male, was 28.9±3.5 years. Traffic accidents were found to be the major cause of splenic injuries (71.3%) and diagnostic peritoneal lavage was frequently used as a diagnostic tool (58.8%).Grades IV andV splenic injuries were seen in 71 patients (75.4%), all of whom required splenectomy. Omentoplasty with partial splenectomy or omentoplasty with splenorrhaphy successfully controlled hemorrhage from the spleen in 22 patients (23.4%). The complication rate was calculated at 18.06% in this study, but no deaths occurred as a direct result of splenic injury. In conclusion, omentoplasty, partial splenectomy, and splenorrhaphy are safe and successful methods of controlling bleeding from a damaged spleen of grade III in patients without multiple injuries.

Key Words

partial splenectomy splenorrhaphy omentoplasty 


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  1. 1.
    Shackford RS, Molin M (1990) Management of splenic injuries. Surg Clin North Am 70:595–619PubMedGoogle Scholar
  2. 2.
    Barron PT, Richter M (1990) Immunodeficiency following splenectomy in the early postimmunization period. Br J Surg 77:316–319CrossRefPubMedGoogle Scholar
  3. 3.
    Cullingford GL, Watkins DN, Watts ADJ, Mallon DF (1991) Severe late postsplenectomy infection. Br J Surg 78:716–721CrossRefPubMedGoogle Scholar
  4. 4.
    Lucas CE (1991) splenic trauma, choice of management. Ann Surg 213:98–112CrossRefPubMedGoogle Scholar
  5. 5.
    Moore EE, Shackford SR, Patcher HL, Mc Aninch JW, Moor JB (1989) Organ injury scaling: spleen, liver and kidney. J Trauma 12:1664–1666CrossRefGoogle Scholar
  6. 6.
    King H, Shumacher HB (1952) Splenic studies. Ann Surg 136:239–242CrossRefPubMedGoogle Scholar
  7. 7.
    Traub A, Giebink GS, Smith C (1987) Splenic reticuloendothelial function after splenectomy spleen repair and spleen autotransplantation. N Engl J Med 317:1559–1564PubMedCrossRefGoogle Scholar
  8. 8.
    Cooper MJ, Williamson RCN (1984) Splenectomy: indications, hazards and alternatives. Br J Surg 71:173–180CrossRefPubMedGoogle Scholar
  9. 9.
    O’Neal BJ, McDonald LC (1981) The risk of sepsis in the splenic adult. Ann Surg 194:775–778CrossRefPubMedGoogle Scholar
  10. 10.
    Topaloĝlu Ü, Odabaşi M, Yilmazcan A, Ünalmişer S (1995) Laparotomy for abdominal trauma. Turkish J Trauma 1:151–154Google Scholar
  11. 11.
    Hill AC, Shecter WP, Trunkey DD (1988) Abdominal trauma and infections for laparotomy. In: Mattox KL, Moore EE, Feliciano DV (eds) Trauma. Appleton and Lange, Norwalk, p 401Google Scholar
  12. 12.
    Fabian TC, Mangiante EC, White TJ (1986) A prospective study of 91 patients undergoing both computed tomography and peritoneal lavage following blunt abdominal trauma. J Trauma 26:602–608CrossRefPubMedGoogle Scholar
  13. 13.
    Davis RA, Shayne JP, Max MH (1985) The use of computerized tomography versus peritoneal lavage in the evaluation of blunt trauma: a prospective study. Surgery 98:845–849PubMedGoogle Scholar
  14. 14.
    Di Cataldo A, Puleo S, Li Destri G (1987) Splenic trauma and overwhelming postsplenectomy infection. Br J Surg 74:343–345CrossRefPubMedGoogle Scholar
  15. 15.
    Anastasios P, Aidonopoulos A, Spiros T, Papavramidis GD, George DG, George GF, Nikolas PD, Ioannin MV (1995) Splenorrhaphy for splenic damage in patients with multiple injuries. Eur J Surg 161:247–251Google Scholar
  16. 16.
    Wisher DH, Blaisdel FW (1992) When to save the ruptured spleen. Surgery 111:121–122Google Scholar
  17. 17.
    Uranüs S, Kronberger L, Kraft-Kine J (1994) Partial splenic resection using the TA-stapler. Am J Surg 168:49–53CrossRefPubMedGoogle Scholar
  18. 18.
    Redmond HP, Redmond JM, Rooney BP, Duignan JP, Bouchier-Hayes DJ (1989) Surgical anatomy of the human spleen. Br J Surg 76:198–201CrossRefPubMedGoogle Scholar
  19. 19.
    Feliciano DV (1990) Splenorrhaphy. Ann Surg 116:651–656Google Scholar
  20. 20.
    Pachter HL (1990) Experience with selective operative and nonoperative treatment of splenic injuries in 193 patients. Ann Surg 211:583–588CrossRefPubMedGoogle Scholar
  21. 21.
    Ellison EC, Fabri PJ (1983) Complications of splenectomy. Surg Clin North Am 63:1313–1330PubMedGoogle Scholar
  22. 22.
    Sekikawa T, Shatney CH (1983) Septic sequelae after splenectomy for trauma in adults. Am J Surg 145:667–673CrossRefPubMedGoogle Scholar
  23. 23.
    Molin MR, Shackford RS (1990) The management of splenic trauma in a trauma system. Arch Surg 125:840–843PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1999

Authors and Affiliations

  • Ümit Topaloĝlu
    • 1
  • Ali Yilmazcan
    • 1
  • Selçuk Ünalmişer
    • 1
  1. 1.Haydarpaşa Teaching HospitalFourth Surgical ClinicIstanbulTurkey

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