Surgical procedures on the spleen have undergone a dramatic change within the last twc decades. Efforts directed toward splenic preservation have been intensified with the realization that diminished immunologic competence and overwhelming sepsis are sequelae that cannot be ignored in asplenic subjects, regardless of the age of the patient or the time interval sincesplenectomy.
Herein, our recent experience with 51 cases of traumatized spleens at Dept. of Surgery,. Kyungpook National University Hospital is reported.
Among 51 cases, we presevered the spleen of 22 cases by splenorrhaphy or non-operative- conservative treatment.
The causes of the splenic injury were mainly due to blunt trauma, especially by traffic- accident.
The sex distribution was 19 males, and 3 females, and 68% of the patient was under the- 20 years old.
The clinical findings on admission were mainly peritoneal irritation signs, and the associated injuries were found in 13 cases.
The scout films of abdomen showed several abnormal findings, such as loss of psoas, renaL or splenic shadow, left side rib fracture, caudal displacement of splenic flexure of colon, medial displacement of stomach, and serrated appearance of the greater curvature of stomach.
The nature of the splenic injuries of 11 cases who underwent splenorrhaphy were 3 minor and 8 major injuries. Complete mobilization of the spleen was performed in all cases, and ten of the 11 cases(91%) were repaired by direct sutures of the ruptured splenic parenchyme. The post-operative complications were found in 5 cases(45%), but there was no complication by splenorrhaphy itself, and no operative mortality.
The spleen scan with 99mTcsu1fur colloid was done on 22 cases which revaeled normal sple? nic figures in 11 cases and abnormal figures in rest of the 11 cases such as non or faint visualization, enlarged spleen and cold area.
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