[Surgical management of blunt splenic trauma]

From 1986 to 1990, 94 patients with blunt splenic trauma were hospitalized and operated on in the Kuang Tien General Hospital. Included were 74 males and 20 females with a mean age of 33 years (range: 5 to 78). The mean duration of the follow-up was 40 months. We classified the severity of the injury according to the splenic injury scale which was published in 1989 by the Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A.A.S.T.). Based on the operative findings, the splenic injuries of the 94 cases were classified as follows: grade I--4 cases, grade II--14 cases, grade III--24 cases, grade IV--41 cases, and grade V--11 cases. Twelve of the patients were treated with splenorrhaphy, and 82 cases underwent splenectomy. The mortality rate was 5.3%, and the morbidity rate, 12.8%. The most frequent postoperative complications in the patients who survived the initial operation were wound infections (4.2%), small bowel obstruction (3.2%), pulmonary infection (3.2%), intra-abdominal abscesses (1.1%), and pancreatitis (1.1%).