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  • Title: Injuries associated with splenic trauma.
    Author: Traub AC, Perry JF.
    Journal: J Trauma; 1981 Oct; 21(10):840-7. PubMed ID: 7277528.
    Abstract:
    Renewed interest in conservative nonoperative management of splenic trauma in children led us to review our experience with this injury in 258 patients over the past 5 1/2 years. Blunt trauma was the predominant type of injury, occurring in 241 patients: 80% of these patients had associated extra-abdominal injuries, predominantly involving the head, chest, and extremities; 59% of patients with penetrating trauma had concomitant extra-abdominal injuries, mainly of the thorax. Serious concomitant intra-abdominal injuries requiring operative therapy were found in 36.5 and 94%, respectively, of patients sustaining splenic injury from blunt and penetrating trauma. Children under the age of 16 years exhibited a similar incidence (32.6 and 100%), respectively). Renal, hepatic, diaphragmatic, intestinal, mesenteric, and vascular injuries were most frequent. The pitfall of conservative nonoperative management lies in missing these concomitant serious intra-abdominal injuries. Diagnostic peritoneal lavage is most useful in defining the patients who should undergo exploratory laparotomy, therefore reducing morbidity and mortality secondary to neglected injuries.
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