CRITERIA FOR NONOPERATIVE MANAGEMENT OF BLUNT SPLENIC TRAUMA

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SARMAST SHOUSHTARI M.H.; ASKARPOUR SH.; ASGARI MAHDI; TALAEIZADEH A.A.H.; SABET MOHAMMAD

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Journal: Tehran University Medical Journal Year:2009 | Volume:66 | Issue:11 Page(s): 835-842

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Title

CRITERIA FOR NONOPERATIVE MANAGEMENT OF BLUNT SPLENIC TRAUMA

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Keywords

ABDOMINAL TRAUMA BLUNTQ3

SPLENIC INJURYQ3

MANAGEMENT NONOPERATIVEQ3

Abstract

Background: Although nonoperative management is as an alternative method for surgery in the management of blunt splenic trauma, there are many contraversies in criteria for appropriate selection of the best method of management in patients. This study was conducted to find clinical and diagnostic criteria for selection of patients for surgery.Methods: One hundred and one patients with blunt SPLENIC INJURY entered in our prospective observational and cross sectional study. Patients with unstable hemodynamics and obvious abdominal symptoms underwent emergency splenectomy was performed. In stable patients, abdominal and pelvic CT scan with IV contrast was performed. Patients with stable hemodynamics who lack obvious abdominal symptoms, admitted in ICU ward. Patients' demographics, blood pressure changes, hemoglobin concertration, severity of trauma with injury severity score (ISS) scoring system, CT scan findings, amount of blood transfusion; Hospitalization time and mechanism of injury were recorded.Results: From 101 patients, 61 (60.3%) underwent early laparotomy. 40 patients were planned for conservative management. In 30 patients (29.7%) nonoperative management was successful. In 10 patients (9.9%) This management failed and they underwent surgery. Hypotension, hemoglobin concentration dropping more than one episode and blood transfusion requirement more than one time, increased the risk of operation. Higher ISS number and ISS ³16 had a direct relation with operative management. In patients who underwent early laparotomy CT grade of injury was higher. CT findings correlated well with laparotomy findings.Conclusion: Nonoperative management was successful in 75% of selected patients.With correct selection of patients and concerning to homodynamic status, hemoglobin concentration changes and injury severity score in conjunction with CT findings, we can use this management in greater number of patients

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APA: Copy

SARMAST SHOUSHTARI, M.H., ASKARPOUR, SH., ASGARI, MAHDI, TALAEIZADEH, A.A.H., & SABET, MOHAMMAD. (2009). CRITERIA FOR NONOPERATIVE MANAGEMENT OF BLUNT SPLENIC TRAUMA. TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ), 66(11), 835-842. SID. https://sid.ir/paper/39459/en

Vancouver: Copy

SARMAST SHOUSHTARI M.H., ASKARPOUR SH., ASGARI MAHDI, TALAEIZADEH A.A.H., SABET MOHAMMAD. CRITERIA FOR NONOPERATIVE MANAGEMENT OF BLUNT SPLENIC TRAUMA. TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)[Internet]. 2009;66(11):835-842. Available from: https://sid.ir/paper/39459/en

IEEE: Copy

M.H. SARMAST SHOUSHTARI, SH. ASKARPOUR, MAHDI ASGARI, A.A.H. TALAEIZADEH, and MOHAMMAD SABET, “CRITERIA FOR NONOPERATIVE MANAGEMENT OF BLUNT SPLENIC TRAUMA,” TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ), vol. 66, no. 11, pp. 835–842, 2009, [Online]. Available: https://sid.ir/paper/39459/en

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