Author : W. Al-Sabounchi, Shareef
Basrah Journal of Surgery,
2003, Volume 9, Issue 1, Pages 31-37
This is retrospective study of splenic trauma managed at Al-Zahrawi Teaching Hospital and Saddam General Hospital in Mosul Province. The data of 108 patients during the study between the first of January 1993 and the 13th of June 1997; have been analyzed. Males were three times affected more than females. The mean age was 24 years, and the highest incidence was encountered in those below the age of 10 years (39.8%). Blunt splenic trauma was much more common than penetrating injury (73% vs 27%). Road traffic accidents (41.7%) and fall from height (25%) were the most common causes. Splenic injuries were graded in severity from one to five. Twelve percent were grade I injuries, 13% grade II, 14% grade III, 16% grade IV, 27% grade V, and 19% of unknown grade. Associated injuries were frequent, occurred in 63% of patients. The majority of the patients (94.4%) were treated by splenectomy whereas only (5.6%) had splenorraphy performed. Delayed rupture of the spleen was present in two patients (1.9%) who required splenectomy more than 48 hours post-injury. Postoperative complications were common, occurred in 47 patients (34.5%). Pulmonary infection had the higher incidence and occurred in (20.4%) of the patients. Wound infection was present in 8 patients (7.4%) and peritonitis in 7 patients (6.4%). However, complications were more frequent in those severely injured with multiple associated injuries. The overall mortality was (25%). Sixteen patients (15%) with blunt splenic injury and 11 patients with penetrating injury died. Death generally occurred in those with severe associated injuries like head injuries. The two most common causes of death were exsanguination (8.3%) and septicemia.