[Preservation surgery in splenic injuries at a type II hospital]

In 1986-1989 in the surgical department of the Pelhrimov hospital nine casualties were treated injuries of the spleen by preserving operations of the latter. In three patients the operation formed part of comprehensive treatment in the abdominal cavity and further treatment because of multiple injuries. In two patients the rupture was treated by a stitch with Gelaspon, in one instance by Gelaspon only. Six times splenectomy was performed with subsequent implantation of the tissue into omentum. All patients with the implantations recovered, except one, with out complications on the part of the implant. The authors present the case-history of a patient where on the 13th day day after operation the implant incl. the omentum had to be removed by relaparotomy. The authors did not encounter this complication in the literature. They ascribe it to the greatly reduced immunity of the patient due not only to the splenectomy but also to associated injuries, and thus healing processes facilitating incorporation of the spleen in the new environment were lacking. Despite this in the authors' opinion implantation of lienal tissue into the omentum, corresponding to one third of the original spleen, is a suitable therapeutic method even in district hospitals.