Splenic artery ligation for traumatic rupture of the spleen. A case report.
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Reports on postsplenectomy septicemia have led to a more conservative attitude to treatment of splenic trauma. A case of traumatic rupture of the spleen treated with splenic artery ligation is presented. In the 5-year follow-up the investigations included repeated scintigraphy. Alternative management of traumatized spleen is discussed.Cite
Every effort is made during surgery of the spleen to preserve splenic function. This serves the purpose of maintaining the integrity of the defence mechanisms of the patient against infection in the short - and long-term. With ligation of the splenic artery prior to excision of splenic lesions and splenic repair we aimed to secure control of peri- operative bleeding, thus, making feasible the preservation of the spleen.Six patients with splenic pathology aged 5-14 years old (four boys and two girls) were operated on for splenic pathology between 1994-1999. Three had splenic cysts (dermoid), one had a hamartoma and 2 had hydatid cysts. Investigations included radiography, ultrasound scan, computerised tomography and scintigraphy. All patients were administered antibiotics and pneumovax pre-operatively. Ligation of the splenic artery was carried out with ligaclips. Congenital anomalies or hydatid cysts were excised and repair of the spleen with splenorrhaphy was performed. Peri-operative blood loss was minimal and this aided greatly in performing the excision of the splenic lesions and the repair of the spleen.All patients had an uncomplicated post-operative course. Scintigraphy in the follow-up from 6 months after the operation showed good splenic function. Laboratory investigations did not show decreased levels of immunological factors in the early or later post- operative period.Splenic artery ligation reduced the amount of bleeding and allowed for the preservation of the spleen in all patients in this study.
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Reports on postsplenectomy septicemia have led to a more conservative attitude to treatment of splenic trauma. A case of traumatic rupture of the spleen treated with splenic artery ligation is presented. In the 5-year follow-up the investigations included repeated scintigraphy. Alternative management of traumatized spleen is discussed.
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Collateral circulation
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[Objective]To discuss the treatment of traumatic splenic rupture with spleen-preserving operation in situ.[Methods]48 of 76 patients with traumatic splenic rupture were treated with spleen-preserving operation.[Results]In 48 patients of spleen-preserving operation in situ,36 cases of grade Ⅲ,Ⅳ splenic rupture were conducted with splenic artery ligation and irregular partial splenectomy,all cured and no complications.[Conclusion]Spleen-preserving operation in situ makes spleen function recover quickly,has few complications.In some conditions,splenic artery ligation and irregular partial splenectomy should be preferred in treating splenic rupture(grade Ⅲ or Ⅳ),which would get better clinical effects.
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