Under what circumstances is the spleen susceptible to injury?
Under what circumstances is the spleen susceptible to injury?
The spleen can rupture when the abdomen suffers a severe direct blow or blunt trauma. The spleen is the most frequent organ to be damaged in blunt trauma injuries involving the abdomen.
What presentation is most consistent with spleen laceration?
The clinical presentation of splenic injury is highly variable. Most patients with minor focal injury to the spleen complain of left upper quadrant abdominal tenderness. Left shoulder tenderness may also be present as a result of subdiaphragmatic nerve root irritation with referred pain.
What are the grades of splenic injury?
There are five grades of splenic injury (Fig. 1; Table 1). Generally, grades I and II are considered as minor injuries, grade III as a moderate injury, and grades IV and V as severe injuries (Figs.
What are the different types of splenic trauma?
Splenic trauma were divided and assessed as type of injury (blunt and penetrating injury) and management (conservative and operative management). Through the Delphi process, the different issues were discussed in subsequent rounds. The central coordinator assembled the different answers derived from each round.
Which is the most common site of spleen injury?
Splenic trauma occurs with liver trauma in 18–48% of cases and with left-sided renal trauma in 10% of cases. Other frequently combined injury sites are the left adrenal, the pancreatic body and tail, the stomach, the left hemidiaphragm, the vertebrae, and the left thoracic base. Left lower ribs are involved in up to 25% of cases of splenic trauma.
Can a liver injury be a splenic injury?
In contrast with liver traumatic injuries, splenic injuries can be fatal not only at the admission of the patient to the Emergency Department (ED), but also due to delayed subcapsular hematoma rupture or pseudoaneurism (PSA) rupture.
What causes a spleen retractor to rip out?
The most common cause is excessive traction on the splenic attachments that rips the splenic capsule. In addition, direct injury during dissection of large tumors may lacerate the splenic capsule, and retractors may damage the spleen if excessive force is placed on them or if countertraction is too great.
When does a splenic injury occur in an adult?
Splenic physiology is discussed in detail elsewhere. (See “Evaluation of splenomegaly and other splenic disorders in adults”, section on ‘Properties of the normal spleen’ .) Splenic injury most commonly occurs following blunt trauma due to motor vehicle collisions (driver, passenger, or pedestrian).
What are the guidelines and guidelines for splenic trauma?
The present guidelines and classification reconsider splenic lesions in the light of the physiopathologic status of the patient associated with the anatomic grade of injury and the other associated lesions. The guidelines are evidence-based, with the grade of recommendation also based on the evidence.
Are there non-operative options for Blunt splenic injury?
Many studies including both pediatric and adult data have demonstrated the non-operative management options in traumatic blunt splenic injury. In 1968, Upadhyaya and Simpson, based on a well-designed clinical analysis of 52 children admitted to the Hospital for Sick Children made a convincing argument for conservative management (2).
What is the salvage rate for splenic injury?
All splenic injury grades had diagnostic angiography. Sixty patients underwent transcatheter embolization, and the overall splenic salvage rate was 98.5%, the highest salvage rate with or without embolization reported to-date.
What would cause a spleen to rupture without trauma?
Common causes of non traumatic splenic rupture include myeloproliferative diseases, vasculitis and infections (such as malaria or infectious mononucleosis).
Can you regrow your spleen?
Unlike some other organs, like the liver, the spleen does not grow back (regenerate) after it is removed. Up to 30% of people have a second spleen (called an accessory spleen). These are usually very small, but may grow and function when the main spleen is removed.
Can a person have a second Spleen after a car accident?
Up to 30% of people have a second spleen (called an accessory spleen). These are usually very small, but may grow and function when the main spleen is removed. Rarely, a piece of the spleen may break off with trauma, such as after a car accident.
How old do you have to be to have a splenectomy?
HS can appear at any age, even in newborns, although doctors prefer to put off removing the spleen until the child is five to six years old. There are some disorders for which a splenectomy is usually recommended. They include: Immune (idiopathic) thrombocytopenic purpura (ITP).
When to consider the long-term consequences of a splenectomy?
Although it used to be said that serious infection was more likely in the first two years after splenectomy, you need to consider your susceptibility to this sort of infection as lifelong.
When does the spleen need to be removed?
The spleen is prone to bleeding when it is injured as a result of abdominal trauma, particularly to the top left hand corner of the abdomen, where the spleen is tucked under the ribs. Surgeons are sometimes forced to remove the spleen (splenectomy) to control the bleeding that results from its injury.
What happens to the spleen after a car accident?
Spleen repair: The surgeon will stitch the ruptured area of the spleen. Partial spleen removal Vs. Complete Splenectomy: If only a portion of the spleen is injured, the doctor may perform a partial splenectomy, wherein he/she will remove the injured portion of the spleen.
What happens if your spleen ruptures due to an abdominal injury?
If your spleen ruptures due to a severe abdominal injury or because of an enlarged spleen (splenomegaly), the result may be life-threatening, internal bleeding. Enlarged spleen. Splenectomy may be done to ease the symptoms of an enlarged spleen, which include pain and a feeling of fullness.
Can a person have their spleen removed laparoscopically?
Patients who are obese or who have scar tissue in the spleen area from a previous operation also may not be able to have their spleen removed laparoscopically. After surgery, you will stay in the hospital for a while so doctors can monitor your condition.
Are there any side effects of a splenectomy?
But as with any surgery, splenectomy carries the potential risk of complications, including: After spleen removal, you’re more likely to contract serious or life-threatening infections. Your doctor may recommend that you receive vaccines against pneumonia, influenza, Haemophilus influenzae type b (Hib) and meningococci.