A retrospective study was done with thirty-five blunt splenic trauma patients who treated nonsurgically at the Department of General Surgery, Pohang Sunlin Hospital during 6 years from January 1988 to December 1993.
@ES The results as follows.
@EN 1) Of the 35 patients evaluated in this study, 28 were men and 7 were women. And the age of the patient raged from 4 to 57 years, with an average age of 25 years.
2) The most common cause of trauma was traffic accident in 22 cases (62.9%).
3) Associated injuries were recorde in 20 cases with intra-abdominal organ in 10 cases (50%) and extra-abdominal region in 20 cases (100%). The most commonly involved involved intra-abdominal organ was left kindney in 7 cases (35%).
4) The diagnostic methods were abdominal CT scan in 32 cases (91.4%), and ultrasonography in 3 cases (8.6%).
5) According to splenic injury scale, Grade II was the most common in 16 cases (45.7%), Grade III was in 11 cases (31.4%), Grade I was in 6 cases (17.2%), and Grade IV was in 2 cases (5.7%).
6) The average transfusion requirements were 1.17 units packed red cells; 0 unit in Grade I, 0.56 unit in Grade II, 0.91 unit in Grade III, and 11.0 units in Crade IV.
7) Among 35 cases, three patients underwent splenectomy due to delayed splenic reupture . And one pateitn with Grade III and two patients with Grade IV.
8) Five patietns developed complications. It included three delayed spleen rupture, one pleural effusion, and one splenic cyst.
9) The average length of hospital stay was 18.3 days and was not longer in those who had a non-surgiacl management than who had a sugical management.
From the results of this study, we concluded that non-surgical manageement of blunt splenic injury would be successful in whom maintaied hemodynamical stability with initial fluid therapy, at status below the Grade IV in splenic injury scale, and
minimal peritoneal irritation sign.
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