RUPTURED SPLEEN IN THE ADULT: AN ACCOUNT OF 205 CASES WITH PARTICULAR REFERENCE TO NON‐OPERATIVE MANAGEMENT

Australian and New Zealand Journal of Surgery - Tập 57 Số 8 - Trang 549-553 - 1987
PapuaNewGuineaSplenicInjuryStudy Group1
1Goroka Base Hospital, Goroka, Papua New Guinea

Tóm tắt

A series of 205 ruptured adult spleens, half of them due to personal assault, has been collected from several hospitals. In some of these cases a trial of non‐operative management has become standard practice unless other abdominal injuries are suspected. One hundred and thirty‐seven cases were managed this way initially, successfully so in 80%. Splenectomy was performed in 70 patients with eight deaths; three of them in the 27 instances where non‐operative management was said to have failed. None of these eight deaths was due to operative delay.

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Tài liệu tham khảo

Garnham P. C. C., 1970, The role of the spleen in protozoal infections with special reference to splenectomy, Acta Trap., 27, 1

10.1001/archinte.137.11.1526

10.1097/00005373-198110000-00003

10.1111/j.1445-2197.1984.tb06703.x

Welch K. J., 1979, The injured child, 174

10.1002/bjs.1800721219

Singer D. B., 1973, Perspectives in pedialric pathology, 1

10.1016/0022-3468(71)90380-0

10.1111/j.1445-2197.1984.tb05419.x

Morgenstern L., 1983, Non‐operative management of injuries of the spleen in adults, Surg. Gynecol. Obstet., 157, 513

10.1111/j.1445-2197.1977.tb04263.x

10.1111/j.1445-2197.1985.tb00884.x

10.1136/jcp.38.3.309

10.1097/00000441-197511000-00015

10.1097/00005373-198020010-00001

Lowry J. B., 1985, Fatal overwhelming sepsis after splenectomy in the community hospital, Can. J. Surg., 28, 357

Malangoni M. A., 1984, Factors influencing the risk of early and late serious infection in adults after splenectomy for trauma, Surgery, 96, 775

10.1016/S0140-6736(77)90132-5

10.1136/bmj.3.5569.825

10.1016/S0140-6736(85)91613-7

Amsbaugh D. F., 1978, Effect of splenectomy on the expression of regulating t‐cell activity, J. Immunol., 121, 1483, 10.4049/jimmunol.121.4.1483

10.1016/S0022-3476(84)80422-9

Kirkland T. N., 1985, Genetic control of resistance to coccidioides immitis: a single gene that is expressed in spleen cells determining resistance, J. Immunol., 135, 152, 10.4049/jimmunol.135.1.548

RileyI. D. LehmannD. AlpersM. P. MarshallT. F.DeC. GrattanH.&SumithD.(1986)Pneumococcal vaccine prevents deaths from acute lower respiratory infection in papua new guinean children (in press).

Kiroff G. K., 1985, Pneumococcal vaccine after splenectomy, Aust. N.Z. J. Surg., 55, 294

10.1001/jama.241.25.2736

10.1056/NEJM197901253000428

Trunkey D. D., 1985, Current emergency diagnosis and treatment., 268

10.1016/S0002-9610(85)80172-0

10.1111/j.1445-2197.1982.tb05407.x

Jourdan G. L., 1981, Complications in surgery and their management., 576

Kocher E. T., 1911, Textbook of operative surgery, 565

10.1002/bjs.1800207809

10.1016/S0140-6736(02)69259-1

Billroth T. H., 1881, Clinical surgery., 229

Polk H. C., 1981, Trauma., 113