Traumatic Splenic Injury: Its Management in a Patient Population With a High Incidence of Associated Injury

Charles D. Livingston, Kenneth R. Sirinek, Barry A. Levine, J. Bradley Aust

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Nonoperative management of splenic trauma is receiving increasing support following delineation of the spleen's role in infection. Controversy regarding the proper management of this injury led us to study retrospectively 236 consecutive patients with splenic trauma. Blunt trauma occurred in the majority (161); the remainder suffered penetrating abdominal injury secondary to gunshot or stab wounds. Diagnostic peritoneal lavage was accurate in establishing splenic injury in blunt trauma (no false-positive, but three false-negative findings). Associated intra-abdominal injury occurred in 48% and 92% of patients with blunt and penetrating trauma, respectively. Diagnostic peritoneal lavage is an accurate method for establishing an intraabdominal injury and the need for abdominal exploration in patients with blunt abdominal trauma. Because of the high rate of associated intra-abdominal injury in splenic trauma, nonoperative management can be expected to result in a disturbing incidence of missed intra-abdominal injury in patients with abnormal peritoneal lavage findings.

Original languageEnglish (US)
Pages (from-to)670-674
Number of pages5
JournalArchives of Surgery
Volume117
Issue number5
DOIs
Publication statusPublished - May 1982

    Fingerprint

ASJC Scopus subject areas

  • Surgery

Cite this