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Splenic injuries in a semi urban hospital in Nigeria
Abstract
Background: The management of splenic injury has changed dramatically over the last two decades. The objective of this study is to evaluate splenic injuries in our community and factors affecting the outcome of treatment modalities.
Methods: A prospective descriptive study of 73 patients treated for splenic injuries in our surgical unit between 1991 and 2006 was carried out. Data were collected on the nature of their injuries, treatment modalities and their outcome. All the data were analyzed using SPSS 13 software for windows.
Results: The ages ranged from 3 to 65 with a mean of 24.2 years. Seventy of these patients sustained their injuries from blunt trauma and road traffic accidents accounted for 55 cases. Forty of these patients sustained isolated splenic injury while the remaining thirty three were multiply injured. Majority of our patients (93.8%) were treated operatively Fifty-three (72.6%) of the 73 patients had splenectomy and twenty (27.4%) had splenic preservation. Post operative complications were recorded in sixteen patients. There were eight deaths all occurring in multiply injured.
Conclusion: Only 6.8% the patients had non-operative management. Factors that significantly affected patients’ recovery and good outcome were: age of the patient, cause of injury, accident and emergency systolic blood pressure, intra-operative blood transfusion and the amount of haemoperitoneum. Vehicular motor accident remains the commonest cause of splenic injury in our community with high rate of associated injuries and the need for inter-specialty care of these patients.
Methods: A prospective descriptive study of 73 patients treated for splenic injuries in our surgical unit between 1991 and 2006 was carried out. Data were collected on the nature of their injuries, treatment modalities and their outcome. All the data were analyzed using SPSS 13 software for windows.
Results: The ages ranged from 3 to 65 with a mean of 24.2 years. Seventy of these patients sustained their injuries from blunt trauma and road traffic accidents accounted for 55 cases. Forty of these patients sustained isolated splenic injury while the remaining thirty three were multiply injured. Majority of our patients (93.8%) were treated operatively Fifty-three (72.6%) of the 73 patients had splenectomy and twenty (27.4%) had splenic preservation. Post operative complications were recorded in sixteen patients. There were eight deaths all occurring in multiply injured.
Conclusion: Only 6.8% the patients had non-operative management. Factors that significantly affected patients’ recovery and good outcome were: age of the patient, cause of injury, accident and emergency systolic blood pressure, intra-operative blood transfusion and the amount of haemoperitoneum. Vehicular motor accident remains the commonest cause of splenic injury in our community with high rate of associated injuries and the need for inter-specialty care of these patients.
