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J Korean Soc Emerg Med > Volume 5(2); 1994 > Article
Journal of The Korean Society of Emergency Medicine 1994;5(2): 250-257.
Won Jae Lee, Kyu Nam Park, Joo Il Hwang, Keun Woo Lim, Se Kyung Kim
Department of Emergency Medicine, Catholic University Medical College
  Published online: December 31, 1994.
The spleen is most commonly injured organ following abdominal trauma and is involved fre­quently in penetrating wounds to the left lower chest, flank, and upper abdomen. Management of the injured spleen has changed radically the over past years. Once regarded as a mysterious organ of unestablished benefit, the spleen is now recoginzed efforts important immunologic fac­tory as well as a reticuloendothelial filter. Recognition of these immunologic consequences has stimulated efforts to conserve splenic mass, irrespective of age. With the appreciation of the spleen's segmental anatomy, advances in operative technique, and the development of topical hemostatic agents, splenorrhaphy has proved to be both feasible and safe. We reviewed retrospectively two hundred and twenty one cases of blunt splenic trauma that were managed Col­lege during last decade of Jan. 1980 to Dec. 1989. The following results were obtained ; 1) Male to Female ratio was 165 : 56 and most frequently injured age group was third dec­ade(20-29) and childhood(0-9). 2) The most common cause of injury was motor vehicle accidents(57.4%), followed by vio­ lent trauma(27%), falling down(14%), stab wound(1%), and others(1%). 3) Expired cases after operation were fifteen and overall motality rate was 6%. 4) Associated injured cases were eighty six(39%), and most frequently associated injury was rib fracture(19.5%), followed by liver(12.2%), kidney(8.1 %), and intestine(7.2%). 5) Surgical management was performed in 214 cases, the most commonly performed procedure was splenectomy(77.8%), next was splenorrhaphy(9%), partial plenectomy(5.5 %), and bleeding control and drainage(4.5 %). 6) Postoperative complications developed in twenty-five cases(11.3%), and pulmonary complication is most common, next was intraabdominal abscess, bowel obstruction, and rebleeding. 7) Overall splenic salvage rate is 22%.
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