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Updated: Jul 16, 2025
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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
238
[Splenectomy via the Transdiaphragmatic Approach]
J Chudáček1, D Klos1, M Gregořík1
1I. chirurgická klinika Fakultní nemocnice Olomouc a Lékařské fakulty Univerzity Palackého v Olomouci.
Acta Chirurgiae Orthopaedicae Et Traumatologiae Cechoslovaca
|September 10, 2023
Summary
A blunt chest trauma case highlights splenic injury as a complication of rib fractures. Emergency thoracotomy revealed lung and diaphragm injuries, leading to an unexpected splenectomy.
Area of Science:
- Trauma Surgery
- Surgical Innovation
- Emergency Medicine
Background:
- Splenic injuries are common in blunt chest and abdominal trauma.
- Fractures of the left 9th to 11th ribs can lead to splenic injury.
- Early diagnosis and management are crucial for patient outcomes.
Observation:
- A 65-year-old male presented with blunt trauma, multiple left rib fractures, left hemothorax, and splenic injury.
- Hemodynamic instability and significant blood loss necessitated emergency left thoracotomy.
- Unexpected findings included a perforated left lung lobe and diaphragmatic ruptures.
Findings:
- Sutures repaired the lung perforation; phrenotomy addressed diaphragmatic ruptures.
- A surprising central splenic rupture required splenectomy.
- Chest wall stabilization was performed post-splenectomy.
Implications:
- The transthoracic approach for splenic injury via phrenotomy is not standard but beneficial in select cases.
- This case demonstrates the complexity of managing concomitant chest and upper abdominal trauma.
- Spleen preservation may not always be feasible in severe blunt trauma scenarios.
