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KMID : 0376119760030010057
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Medical Journal of the Red Cross Hospital
1976 Volume.3 No. 1 p.57 ~ p.63
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Clinical Observation of Traumatic Rupture of the Spleen
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Abstract
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This paper reports our experience with 31 cases of traumatic rupture of the spleen, which were treated at Seoul Red Cross Hosp. for a four year period from April 1968 to August 1972.
1. There were 30 cases of nonpenetrating injury, where as only 1 case of penetrating injury.
2. It was found that patients -between 10 and 40 years of age occupied 80.3% of all cases, and peak age incidence was 3rd and 4th decade respectively in equal number.
3. Male has great dominance over female in sex ratio of 23 to 8.
4. In regard to mode of injury, in order of frequency, traffic accident was committed, in 17 cases (54.8%), falling in 6 cases (19.4%), violence in 5 cases(16. 1%) and crushing, stabbing in each 1 case.
5. 51. 7% of injured patient has management and operations within -8 hours after injuries.
6. Among 26 cases who checked plain abdomen, 17 cases(65.4%) received suggestion of hemoperitoneum or specific splenic rupture.
7. Abdominal tapping was performed in 18 cases, positive. result was found in all.
8. Among 31 cases of splenic- rupture, 6 cases were limited to the splenic injury only, but 8 cases were associated with retroperitoneal hemorrhage, 6 cases with multiple rib fracture, 4 cases with diaphragmatic and mesenteric rupture in each and 2 cases with colon perforation.
9. The most frequent type of injury was laceration of splenic pulp and capsule of 16 cases, the next is disruption of Hilary vessels of 7 cases, and there were 2 cases of delayed hemorrhage, which was raised from subcapsular hematoma.
10. The amount of blood loss was mentioned in 17 cases being average amount of 1, 500ml.
11. All of 31 cases received splenectomy, and incidental appendectomyperpormed in .8 cases, repair of diaphragm in 4 cases and nephrectomy in 2 cases.
12. During postoperative 7th to 21st day, peripheral blood smear was examined in 11 cases and it was found that splenectomy was associated with mild to moderate polychromatophilic, erythrocytosis, giant form thrombocytosis and hypersegmented neutrophilia.
13. The postoperative -complications were occurred in 10 cases (32.3%) and , one of the most common complications was ,unknown mild fever.
14. Mortality rate was 6.5% 2 cases).
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