Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지

Clinical Outcomes of Splenic Injury

비장 손상의 임상적 치료 결과

  • Baek, Seung Hyun (Department of Surgery, Pusan National University Postgraduated School of Medicine) ;
  • Park, Sung Jin (Department of Surgery, Pusan National University Postgraduated School of Medicine) ;
  • Kim, Jae Hoon (Department of Surgery, Pusan National University Postgraduated School of Medicine) ;
  • Kim, Hyun Seong (Department of Surgery, Pusan National University Postgraduated School of Medicine) ;
  • Kim, Dae Hwan (Department of Surgery, Pusan National University Postgraduated School of Medicine) ;
  • Jo, Hong Jae (Department of Surgery, Pusan National University Postgraduated School of Medicine) ;
  • Seo, Hyung-Il (Department of Surgery, Pusan National University Postgraduated School of Medicine)
  • 백승현 (부산대학교 의과대학 외과학교실) ;
  • 박성진 (부산대학교 의과대학 외과학교실) ;
  • 김재훈 (부산대학교 의과대학 외과학교실) ;
  • 김현성 (부산대학교 의과대학 외과학교실) ;
  • 김대환 (부산대학교 의과대학 외과학교실) ;
  • 조홍재 (부산대학교 의과대학 외과학교실) ;
  • 서형일 (부산대학교 의과대학 외과학교실)
  • Received : 2012.05.03
  • Accepted : 2012.06.07
  • Published : 2012.12.31
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Abstract

Purpose: The management of splenic injuries has shifted from a splenectomy to splenic preservation owing to immunity. The purpose of this study was to assess the kinds of management and outcomes through a review of our experience with splenic injuries. Methods: We retrospectively reviewed 47 patients with traumatic splenic injuries using by electronic medical records from Jan. 2007 and Dec. 2011. Splenic injuries were classified according to the American Association for the Surgery of Trauma (AAST) grading system. Results: There were 11 falls, 11 traffic accidents, 10 motorcylcle accidents, 10 pedestrian accidents and 5 abdominal blunt traumas. Low-grade injured patients (${\leq}$ Grade III) were 29 of 43(61.7%), and High-grade injured patients (${\geq}$ Grade IV) were 18 of 43(38.3%). In 34 patients, non-surgical treatment was performed, and 14 patients underwent a splenectomy. There were relatively more high-grade in older patients, and the high-grade-injury group showed need for a transfusion (p=0.002), more need for a splenectomy (p<0.001), a longer mean hospital stay (p=0.036), a longer ICU stay (p=0.045) and more combined organ injury (p=0.036). Conclusion: Conservative treatment should be considered in low-grade-injury patients (${\leq}$ Grade III). A Splenectomy was performed on 56% of the patients with Grade IV injuries, so a splenectomy should be considered carefully in such patients. In patients with a grade V injury, we think surgical treatment may be needed.

Keywords

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