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Splenic trauma, the way forward in reducing splenectomy: our 15-year experience
H Jesani1, L Jesani1, A Rangaraj2
1Department of General Surgery, Royal Gwent Hospital, Newport, UK.
Annals of the Royal College of Surgeons of England
|January 8, 2020
Summary
This study reviewed 126 traumatic splenic injury cases over 15 years. Despite increased non-operative management, splenectomy rates remain high, highlighting the need for standardized care pathways.
Area of Science:
- Trauma Surgery
- Radiology
- Emergency Medicine
Background:
- Traumatic splenic injury management has evolved.
- Assessing radiological assessment, management, and outcomes is crucial.
Purpose of the Study:
- To analyze radiological assessment, management, and outcomes of traumatic splenic injury over 15 years.
- To evaluate trends in management strategies and their impact on patient outcomes.
Main Methods:
- Retrospective review of 126 traumatic splenic injury cases (2002-2017).
- Analysis of radiological (CT) and operative records.
- Assessment of American Association for the Surgery of Trauma (AAST) grading and management outcomes.
Main Results:
- 126 patients with traumatic splenic injury identified; 43% underwent operative management.
- Selective non-operative management increased significantly (42% to 62%).
- AAST grading reporting remained suboptimal (7% to 20%); overall hospital mortality was 10.3%.
Conclusions:
- AAST grading reporting for splenic injuries is suboptimal.
- Despite increased non-operative management, operative intervention, particularly splenectomy, remains high.
- Standardized multidisciplinary pathways are needed to reduce trauma-induced splenectomy.
