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Traumatismes isolés de la rate chez l'adulte

Aguilar, M
Published in Annales de chirurgie. 1998, vol. 52, no. 10, p. 983-7
Abstract The data of 62 adult patients with isolated blunt splenic trauma were retrospectively analysed to determine the value of a CT score-system in the choice of treatment: nonoperative treatment versus surgical management. 22 patients (35%) without hemodynamic instability presenting with pain localized in the left flank were primarily managed conservatively. 3 of them subsequently required splenectomy. 40 patients (65%) were operated immediately, 32 on the basis of clinical criteria and 8 on the basis of laboratory criteria. 45 patients with no initial haemodynamic disorders were investigated by abdominal CT-scan. Splenic injuries were retrospectively classified according to Resciniti's CT-scoring system. 13 patients had a splenic injury score > or = 5.5. All of them were operated, 11 early and 2 after failure of conservative management. According to our study this score > or = 5.5, which concerns 21% of our patients, can be considered to be an indication for surgery; in this case, a conservative approach should not be at tempted, even in the absence of immediate clinical and laboratory operative criteria.
Keywords Abdominal Pain/classification/etiologyAdultDecision MakingFemaleHumansMalePrognosisRetrospective StudiesSpleen/injuries/radiography/surgerySplenectomyTomography, X-Ray ComputedWounds, Nonpenetrating/classification/radiography/surgery
PMID: 9951098
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Research group Chirurgie viscérale (104)
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FROMENT, Philippe Alexandre et al. Traumatismes isolés de la rate chez l'adulte. In: Annales de chirurgie, 1998, vol. 52, n° 10, p. 983-7. https://archive-ouverte.unige.ch/unige:74027

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