Splenic trauma - our experience at a level I Trauma Center

BACKGROUND A retrospective study was performed to identify the effect of non - operative management on splenic trauma patients and its implications at our Level I Trauma Centrer between January 2007 and June 2008. METHODS Data regarding patient demography, mode of splenic injury, computerized tomography (CT) grading, blood transfusion requirement, operative findings, hospital stay, and follow-up were collected. The results of abdominal sonography and CT scan were utilized as proof of splenic injury and to determine the grade of injury. Subjects were divided into splenectomy and non-operative groups. Results were analyzed using non-parametric Mann-Whitney U tests. RESULTS Sixty-seven patients were enrolled in this study. All patients with grade I injury and 12 of 13 patients with grade II injury were managed non-operatively, whereas 9 of 16 patients with grade III injuries, 12 of 14 patients with grade IV injuries and all patients with grade V injuries were managed operatively. Thus, the higher the grade of injury, the greater the likelihood of operative management. The mean Injury Severity Score of the operative group was 20.12, significantly higher (p=0.001) than in the non-operative group, at 11.9. Mean hospital stays in the operative and non-operative groups were 12.8 and 8.3 days, respectively. CONCLUSION Non-operative management of splenic trauma can be performed with an acceptable outcome.