Page 1 of 1: surgery: splenic trauma

vikas1000 · Credits: 3319 My Scrapbook

recommended treatment for splenic trauma below 5 yrs of age....
1.laparotomy and splenectomy
2.nonoperative treatment and observation in hospital
3.laparotomy suture of spleen and autotransplant
4.laparoscopy

cingulate_gyrus2006 · Credits: 22810 My Scrapbook

Again a difficult question ..
If the patient is haemodynamically stable better is nonoperative management.

Nelson says.
Indications for laparotomy include persistent hemodynamic instability, the need for repeated transfusions (~40/mL/kg/24/hr), and bowel perforation. Splenic repair if possible is preferable to splenectomy in cases of severe splenic injury.(Nelson 17th ed p 315)

So answer here can be 2 or 3.

Accoring to the frame of question the examiner is expecting answer as 3

Preferably 3.
Since less tha 5 yrs. Spleen is very important as a part of immunization against capsulated organisms...

drsmita_s · Credits: 18659 My Scrapbook

this is a tricky question indeed, thanks cingulate for all those lines from nelson. i agree that the examiner is probably expecting option 3 from us. one thing is clear that there has been splenic trauma , so in moxt probability opiton 3 is the answer.

vikas1000 · Credits: 3319 My Scrapbook

hellow,
answer given is splenectomy.

but i also thing that conservative management is preferred in children
and also in adults.

stem of the question is inadequate and we can not find out the grade of the injury.

if we consider there is splenic laceration with haemodynamic stability then answer wiil be 3.

but again the role of autotransplantaion of spleen is experimental and not proved.

in children under 14 years of age, more aggressive attempts at intraoperative splenic salvage are justified. Splenic autotransplantation with a free-graft for maintenance of specific splenic immunity is still experimental and of unproven efficacy.

jabby · Credits: 3703 My Scrapbook

SPLENECTOMY IF PT IS UNSTABLE/HIGH GRADE INJURY.

drbalaji · Credits: 227 My Scrapbook

depends on the age of the patient but given the fact that the age is less than 5 years and that nearly 2/3 of splenic injuries can be managed conservatively esp in children(sabiston 17th ed)......the choice wud be non operative treatment

kashya · Credits: 121 My Scrapbook

ali_mdgs · Credits: 126 My Scrapbook

I think the answer is 2 .
* sabiston ( Currently, 70% to 90% of children with splenic injury are successfully treated without operation, and 40% to 50% of adult patients with splenic injury are managed nonoperatively in large-volume trauma centers.)

* Schwartz's Principles of Surgery > Part II. Specific Considerations > (. Current treatment involves a nonoperative approach in most cases, even for grade IV injuries, providing the patient is hemodynamically stable. )

simba7ligo · Credits: 305 My Scrapbook

hi. i am only going to say what surgeon in really practice say. if the patient is haemodynamically stable then conservative management if not then surgically management

jayanta · Credits: 35953 My Scrapbook My Reading List 45 Books

IN THE MODERN ERA OF SPLENIC CONSERVATION ,IF THE PATIENT IS STABLE,ALWAYS GO FOR THE SPLENIC CONSERVATION WITH CLOSE MONITORING.
REGARDS.

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