Spleen injure treatment results analysis

Abstract

Introduction: In the case of abdominal injuries the statistics of the spleen damage is 57% while the mortality - up to 36,6%. Most cases of spleen injuries require splenectomy which may result in multiple early and late postoperative complications and even death (21,4%). The post-splenectomy syndrome that appears to be a common complication has a negative impact upon the patient’s quality-of-life index and social adaptation. Goals: The analysis of the treatment results and the assessment of the quality-of-life index in the case of patients who undergone splenectomy compared to the patients who undergone organ-preserving operations and non-operative treatment methods. Objectives: 1. Research of the frequency and type of early post-splenectomy complications in case of patients who undergone splenectomy compared to patients who undergone organ-preserving operations and non-operative treatment methods. 2. Research of the frequency and type of late post-splenectomy complications in case of both group’s patients. Materials and Methods: The authors have studied 48 medical records and carried out a survey of 46 patients who had suffered from spleen injury and undergone treatment at the National Scientific-Practic Center of Emergency Medicine, RM, 2009-2011. Results and Discussion: The average age of the researched group was 38,72± 17,93. Early complications in the case of post-splenectomy patients have appeared in the case of 60% of patients, 44,66% being infectious complications; in the case of patients who undergone organ-preserving operations - 6,25% while the late complications. The late post-operative period in the post-splenectomy patients’ group was marked by a larger number of infectious complications’ cases (36,33±14,99 compared to 36,33±14,99 and 14,44±7,24 in two other groups) and by a significantly lower quality-of-life index. Conclusions: 1. The frequency of early complications in the post-splenectomy group is 9 times higher than in the case of the group of patients who undergone organ-preserving operations. Most complications are caused by infections (pneumonia, sub-diaphragmatic abscess, peritonitis). 2. The late complications in the post-splenectomy group have a mostly infectious nature (increased incidence of infections and increased frequency of chronic diseases’ exacerbations). The use of organ preserving tactics in cases of spleen injuries allows to improve the quality-of-life index of operated patients in the late post-operative period.