SPLENIC INJURIES AND CLINICAL ANALYSIS

Abstract

Vikas Agrawal1, Sumit Dahiya2, Boni Krishna Chaitanya3, Sai Bharat Sunkara4, Garima Sarawgi5, Unmesh Kumar Jena6

BACKGROUND
Trauma being the most underrated killer of the young needs more careful management. Spleen is the most common intraabdominal injured organ in blunt trauma cases. An adequate clinical analysis, assessment of the patients, diagnosis and treatment with high suspicion of any concealed injury within the abdomen is a must. My study comprises a comprehensive study of cases with splenic injury, mechanism of injury, clinical presentation, grading the injury and accordingly the most appropriate management.
MATERIALS AND METHODS
Prospective observational study at Hi-Tech Medical College and Hospital from July 20, 2014, to July 20, 2017. 30 patients with splenic injury were first assessed in the casualty, primary survey done according to ATLS, once patient is stable; secondary and tertiary survey carried out, relevant data collected and all patients managed under standard protocol to assess the outcome and establish better treatment plans.
RESULTS
Most patients were young adult, presented to the hospital within four hours of injury, most common cause was high speed road traffic accident. 90% patients had abdominal signs. Investigations showed most patients had isolated splenic injury with 40% grade I. 40% patients were conservatively managed, rest 60% operated (repair/resection). Three patients died.
CONCLUSION
Young working class, living in urban areas with a fast life (high-speed traffic and industrial injuries) are more prone for splenic injury, increasing financial and social burden. Early presentation to hospital, meticulous monitoring, adequate grading and prompt investigations leads to early diagnosis and optimum treatment of such patients; thus improving healthcare outcomes.

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