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The avoidable complications of splenectomy

Surgery, Gynecology & Obstetrics

|October 1, 1977

Summary

This summary is machine-generated.

Accidental spleen injury during surgery often leads to splenectomy, causing significant morbidity and mortality. Topical hemostatic agents like Avitene can effectively treat capsular avulsion injuries, potentially avoiding spleen removal.

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Area of Science:

Surgical Pathology
Trauma Surgery
Surgical Hemostasis

Background:

Operative splenic injury leading to splenectomy is a frequent complication, accounting for 25% of all splenectomies.
This complication carries a high morbidity rate exceeding 50% and a mortality rate as high as 15%.

Purpose of the Study:

To evaluate the efficacy of topical hemostatic agents in preventing splenectomy due to operative splenic capsular avulsion injuries.
To highlight the importance of understanding splenic peritoneal anatomy for injury prevention.

Main Methods:

Review of cases involving operative splenic injury and capsular avulsion.
Application of topical hemostatic agents, specifically microfibrillar collagen (Avitene), to manage bleeding.
Analysis of outcomes to determine if splenectomy was averted.

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Main Results:

Topical hemostatic agents, particularly Avitene, have proven effective in managing capsular avulsion injuries.
Splenectomy was averted in 21 reported instances of operative splenic injury.
In the most recent 15 cases where splenectomy was avoided, Avitene was the hemostatic agent used.

Conclusions:

Understanding splenic peritoneal anatomy and prophylactic measures can reduce injury incidence.
Microfibrillar collagen (Avitene) is a valuable tool for managing splenic capsular avulsion injuries, potentially preventing the need for splenectomy.
Effective management of operative splenic injuries can significantly decrease associated morbidity and mortality.