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2015 ; 23
(ä): 85
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The treatment of spleen injuries: a retrospective study
#MMPMID26514334
Dehli T
; Bågenholm A
; Trasti NC
; Monsen SA
; Bartnes K
Scand J Trauma Resusc Emerg Med
2015[Oct]; 23
(ä): 85
PMID26514334
show ga
BACKGROUND: Hemorrhage after blunt trauma is a major contributor to death after
trauma. In the abdomen, an injured spleen is the most frequent cause of major
bleeding. Splenectomy is historically the treatment of choice. In 2007,
non-operative management (NOM) with splenic artery embolization (SAE) was
introduced in our institution. The indication for SAE is hemodynamically stable
patients with extravasation of contrast, or grade 3-5 spleen injury according to
the Abbreviated Organ Injury Scale 2005, Update 2008. We wanted to examine if the
introduction of SAE increased the rate of salvaged spleens in our trauma center.
METHOD: All patients discharged with the diagnosis of splenic injury in the
period 01.01.2000 - 31.12.2013 from the University Hospital of North Norway
Tromsø were included in the study. Patients admitted for rehabilitation purposes
or with an iatrogenic injury were excluded. RESULTS: A total of 109 patients were
included in the study. In the period 2000-7, 20 of 52 patients were
splenectomized. During 2007-13, there were 6 splenectomies and 24 SAE among 57
patients. The reduction in splenectomies is significant (p < 0.001). There is an
increase in the rate of treated patients (splenectomy and SAE) from 38 to 53 % in
the two time periods, but not significantly (p = 0.65). CONCLUSION: The rate of
salvaged spleens has increased after the introduction of SAE in our center. TRIAL
REGISTRATION: The study is registered at www.clinicaltrials.gov with the
identification number NCT01965548.