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  • Title: Splenectomy for trauma: morbidity, mortality and associated abdominal injuries.
    Author: Pitcher ME, Cade RJ, Mackay JR.
    Journal: Aust N Z J Surg; 1989 Jun; 59(6):461-3. PubMed ID: 2735876.
    Abstract:
    Management of ruptured spleen still frequently requires splenectomy. A retrospective analysis of patients undergoing splenectomy for trauma at Box Hill Hospital, Melbourne, over a 14-year period was conducted; 141 of 145 cases were due to blunt trauma. The mortality rate was 10% and all deaths occurred as a result of road traffic accidents. The overall complication rate was 43%, varying from 25% in those with an isolated splenic injury to 100% with multiple system injuries. There was zero incidence of associated intra-abdominal injury in the group sustaining a ruptured spleen as a result of a fall, assault or sporting injury, in contrast to a nearly 50% incidence following road traffic and bicycle accidents. Whether these associated injuries would have been neglected had laparotomy for splenic trauma not been performed is uncertain, and so non-operative management of splenic trauma remains contentious, particularly in cases following vehicular accidents.
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