RT Book, Section
A1 Ellison, E. Christopher
A1 Zollinger, Robert M.
SR Print(0)
ID 1127273824
T1 SPLENIC CONSERVATION
T2 Zollinger's Atlas of Surgical Operations, 10e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179755-9
LK accesssurgery.mhmedical.com/content.aspx?aid=1127273824
RD 2024/04/20
AB Injury  to  the  spleen  is  one  of  the  more  serious  problems  associated  with  trauma.  Emergently  there  is  the  possibility  of  exsanguination.  However,  for  the  remainder  of  the  patient’s  life  after  splenectomy,  there  is  the  possibility  of  catastrophic  bacterial  infection  with  encapsulated  organisms,  such  as  pneumococci,  especially  in  the  very  young.  This  has  stimulated  clinicians  to  conserve  the  spleen  with  or  without  operation.  Nonoperative  treatment  in  children  is  often  successful  if  careful  monitoring  is  provided  in-hospital  and  thereafter  at  home  until  full  healing  is  documented.  In  addition,  in  adults  as  well  as  in  children,  splenorrhaphy  is  often  possible,  as  it  is  desirable  to  salvage  as  much  of  the  traumatized  spleen  as  possible.  It  is  uncertain  how  much  retained  spleen  is  essential  to  provide  normal  protection  for  the  patient,  but  many  recommend  preservation  of  half  or  more  if  possible.  The  surgeon  must  appreciate  that  it  is  essential  to  control  exsanguination  and  that  total  splenectomy  should  be  performed  for  splenic  fractures  that  are  massive  or  that  cannot  be  easily  controlled  in  the  presence  of  continued  major  hemorrhage.