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Journal of the Korean Society of Traumatology 2012;25(2):44-48.
Clinical Outcomes of Splenic Injury
Seung Hyun Baek, Sung Jin Park, Jae Hoon Kim, Hyun Seong Kim, Dae Hwan Kim, Hong Jae Jo, Hyung Il Seo
Department of Surgery, Pusan National University Postgraduated School of Medicine, Busan, Korea. seohi71@hanmail.net
비장 손상의 임상적 치료 결과
백승현∙박성진∙김재훈∙김현성∙김대환∙조홍재∙서형일
부산대학교 의과대학 외과학교실
Received: 3 May 2012   • Revised: 1 June 2012   • Accepted: 7 June 2012
Abstract
PURPOSE
The management of splenic injuries has shifted from a splenectomy to splenic preservation owing to immunity. The purpose of this study was to assess the kinds of management and outcomes through a review of our experience with splenic injuries.
METHODS
We retrospectively reviewed 47 patients with traumatic splenic injuries using by electronic medical records from Jan. 2007 and Dec. 2011. Splenic injuries were classified according to the American Association for the Surgery of Trauma (AAST) grading system.
RESULTS
There were 11 falls, 11 traffic accidents, 10 motorcylcle accidents, 10 pedestrian accidents and 5 abdominal blunt traumas. Low-grade injured patients (< or =Grade III) were 29 of 43(61.7%), and High-grade injured patients (> or =Grade IV) were 18 of 43(38.3%). In 34 patients, non-surgical treatment was performed, and 14 patients underwent a splenectomy. There were relatively more high-grade in older patients, and the highgrade-injury group showed need for a transfusion (p=0.002), more need for a splenectomy (p<0.001), a longer mean hospital stay (p=0.036), a longer ICU stay (p=0.045) and more combined organ injury (p=0.036).
CONCLUSION
Conservative treatment should be considered in low-grade-injury patients (< or =Grade III). A Splenectomy was performed on 56% of the patients with Grade IV injuries, so a splenectomy should be considered carefully in such patients. In patients with a grade V injury, we think surgical treatment may be needed.
Key Words: Splenic injury; Trauma; Splenectomy; Non-surgical treatment


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