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Organerhaltende Therapie der Kindlichen Milzruptur

Organ sparing therapy of spleen ruptures in children

  • Fortsetzung Leitthematik: Der Unfall im Kindesalter
  • Published:
Unfallchirurgie Aims and scope Submit manuscript

Zusammenfassung

Splenektomierte Patienten-insbesondere Kinder-sind durch eine evtl. tödlich verlaufende Postsplenektomiesepsis gefährdet. Eine Exstirpation der Milz sollte daher bei der Ruptur möglichst vermieden werden. Das diagnostische Vorgehen bei Verdacht auf eine Milzruptur sowie die mögliche konservative Behandlung und die verschiedenen operativen Therapiemöglichkeiten werden anhand von 6 Kindern geschildert, die in den vergangenen 21/2 Jahren wegen einer Ruptur des Organs behandell wurden. Bei 5 Kindern konnte die Milz erhalten werden.

Abstract

Splenectomized patients-especially children-run the risk of a possibly lethal postoperational sepsis. Therefore an extirpation of the ruptured spleen should be avoided, if possible. Six children treated for a rupture of this organ within the last 21/2 years are presented in order to describe the diagnostic proceeding in case of suspected spleen rupture as well as the possible conservative treatment and the different surgical possibilities. The spleen could be preserved in five children.

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Literatur

  1. Balfanz, J. R., J. M. E. Nesbit, C. Jarvis, W. Krivit: Overwhelming sepsis following splenectomy. J. Pediat. 88 (1976), 458

    Article  PubMed  CAS  Google Scholar 

  2. Belohradsky, B. H., R. Roos, S. Däumling, R Elsser: Polyvalente Pneumokokken-Vakzine. Mschr. Kinderheilk. 129 (1981), 183.

    CAS  Google Scholar 

  3. Berger, E.: Die Verletzungen der Milz und ihre chirurgische Behandlung. Arch. klin. Chir. 68 (1902), 865.

    Google Scholar 

  4. Böttcher, W., R. M. Seufert, U. Heusermann, D. Munz: Die Autotransplantation der Milz im Tierexperiment. Clearancefunktion, Durchblutung und Histologie. Langenbecks Arch. Chir., Suppl. Chir. Forum (1981), 211.

  5. Buntain, W. L., H. B. Lynn: Splenorrhaphy: Changing concepts for the traumatized spleen. Surgery 86 (1979), 748.

    PubMed  CAS  Google Scholar 

  6. Burrington, J. D.: Surgical repair of a ruptured spleen in children. Arch. Surg. 112 (1977), 417.

    PubMed  CAS  Google Scholar 

  7. Carlisle, H. N., S. Saslaw: Properdin levels in splenectomized persons. Proc. Soc. exp. Biol. 102 (1959), 150.

    CAS  Google Scholar 

  8. Dickerman, J. D., S. R. Horner, J. A. Coil, D. W. Gump: The protective effect of intraperitoneal splenic autotransplants in mice exposed to an aerosolized suspension of type III streptococcus pneumoniae. Blood 54 (1979), 354.

    PubMed  CAS  Google Scholar 

  9. Ein, S. H., B. Shandling, J. S. Simpson, C. A. Stephans, S. K. Bandi, W. D. Biggar, M. H. Freedman: The morbidity and mortality of splenectomy in childhood. Ann. Surg. 185 (1977), 307.

    Article  PubMed  CAS  Google Scholar 

  10. Eraklis, A. J., R. M. Filler: Splenectomy in childhood: A review of 1413 cases. J. pediat. Surg. 7 (1972), 382.

    Article  PubMed  CAS  Google Scholar 

  11. Ernström, U., G Sandberg: Influence of splenectomy on thymic release of lymphocytes in the blood. Scand. J. Haemat. 7 (1970), 342.

    PubMed  Google Scholar 

  12. Goldhorn, J. F., A. D. Schwartz, A Swift, J. A. Winkelstein: Protective effect of residual splenic tissue after subtotal splenectomy. J. pediat. Surg. 13 (1978), 587.

    Article  Google Scholar 

  13. Hodgson, J. B., A. J. McElkinney: Ultrasonic partial splenectomy. Surgery 91 (1982), 346.

    PubMed  CAS  Google Scholar 

  14. Höllerl, G.: Versorgung der verletzten Milz mittels Fibrinklebung, Infrarot-Kontakt-Koagulation und Laserkoagulation. Acta chir. Austriaca, Suppl. 37 (1981), 3.

    Google Scholar 

  15. Höllwart, M., G. Breisach: Konservative Therapie der posttraumatischen Milzruptur. chirurg 49 (1978), 711.

    Google Scholar 

  16. Keramides, D. C.: The ligation of the splenic artery in the treatment of traumatic rupture of the spleen. Surgery 85 (1979), 530.

    Google Scholar 

  17. King, H., H. B. Schumacker: Splenic studies I: Susceptibility to infection after splenectomy performed in infancy. Ann. Surg. 136 (1952), 239.

    PubMed  CAS  Google Scholar 

  18. Livaditis, A., G. Sandberg: Splenic autotransplantation: An experimental study. Z. Kinderchir. 29 (1980), 148.

    Google Scholar 

  19. Morgenstern, L., S. J. Shapiro: Techniques of splenic conservation. Arch. Surg. 114 (1979), 449.

    PubMed  CAS  Google Scholar 

  20. Morris, D. H., F. D. Bullock: The importance of the spleen in resistance to infection. Ann. Surg. 70 (1919), 513.

    Article  PubMed  CAS  Google Scholar 

  21. Najjar, V. A., K. Niskioka: “Tuftsin”: A natural phagocytosis stimulating peptid. Nature 228 (1970), 672.

    Article  PubMed  CAS  Google Scholar 

  22. Patel, J., J. S. Williams, J. O. Naim, J. R. Hinshaw: Protection against pneumococcal sepsis in splenectomized rats by implantation of splenic tissue in an omental pouch. Surgery 91 (1982), 638.

    PubMed  CAS  Google Scholar 

  23. Pringle, K. C., D. Rowley, J. D. Burrington: Immunologic response in splenectomized and partially splenectomized rats. J. pediat. Surg. 15 (1980), 531.

    PubMed  CAS  Google Scholar 

  24. Ratner, M. H., E. Garrow, V. Valde, V. L. Shaskikumar, L. A. Somers Surgical repair of the injured spleen. J. pediat. Surg. 12 (1977), 1019.

    Article  PubMed  CAS  Google Scholar 

  25. Robinette, C. D., J. F. Fraumeni: Splenectomy and subsequent mortality in Veterans of 1939–1945 war. Lancet 2 (1977), 127.

    PubMed  CAS  Google Scholar 

  26. Scheele, J.: Erste klinische Erfahrungen mit der Fibrinklebung bei traumatischer und intraoperativer Milzverletzung. Chirurg 52 (1981), 531.

    PubMed  CAS  Google Scholar 

  27. Schwartz, A. D., M. Dadash-Zadek, P. Goldstein, S Luck, J. J. Conway: Antibody response to intravenous immunisation following splenic tissue autotransplantation in Sprague-Dawley rats. Blood 49 (1977), 779.

    PubMed  CAS  Google Scholar 

  28. Sherman, R.: Perspectives in management of trauma to the spleen: 1979 Presidential Address, American Association for the Surgery of Trauma. J. Trauma 20 (1980), 1.

    Article  PubMed  CAS  Google Scholar 

  29. Sherman, N. J., M. J. Asch: Conservative surgery for splenic injuries. Pediatrics 61 (1978), 267.

    PubMed  CAS  Google Scholar 

  30. Singer, D. B.: Postsplenectomy sepsis. Perspect. pediat. Path. 1 (1973), 285.

    PubMed  CAS  Google Scholar 

  31. Tavalassi, M., J. Ratzau, W. Crosby: Studies on the regeneration of heterotopic splenic autotransplants. Blood 44 (1973), 701.

    Google Scholar 

  32. Touloukian, R. J., C. V. Dang, V. J. Caride: Splenic function following splenic dearterialisation injury in the suckling rat. J. pediat. Surg. 13 (1978), 131.

    Article  PubMed  CAS  Google Scholar 

  33. Vega, A., C. Howell, J. Krasna, J. Campos, S. Heyman, M. Ziegler, C. E. Koop: Splenic autotransplantation: optimal functional factors. J. pediat. Surg. 16 (1981), 898.

    Article  PubMed  CAS  Google Scholar 

  34. Walker, W.: Splenectomy in childhood: Review in England and Wales 1960–1964. Brit. J. Surg. 63 (1976), 36.

    Article  PubMed  CAS  Google Scholar 

  35. Wesson, D. E., R. M. Filler, B. Shandling, J. S. Simpson, C. A., Stephans: Ruptured spleen-when to operate. J. pediat. Surg. 16 (1981), 324.

    Article  PubMed  CAS  Google Scholar 

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Author notes

  1. W. Lambrecht

    Present address: Abteilung für Allgemeinchirurgie, Chirurgische Universitätsklinik Hamburg, Martinistraße 52, D-2000, Hamburg 20

Authors and Affiliations

  1. Abteilung für Allgemeinchirurgie, Chirurgische Universitätsklinik Hamburg, Martinistraße 52, D-2000, Hamburg 20

    M. Heller

  2. Radiologische Universitätsklinik Hamburg, Hamburg, Deutschland

    W. Lambrecht & M. Heller

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  1. W. Lambrecht
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  2. M. Heller
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Lambrecht, W., Heller, M. Organerhaltende Therapie der Kindlichen Milzruptur. Unfallchirurgie 10, 66–72 (1984). https://doi.org/10.1007/BF02588380

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