Articles Vol. 64 No. 4 28/07/2023

4. CLINICAL AND PARACLINICAL CHARACTERISTIC OF BLUNT SPLENIC PATIENTS UNDERGOING SPLENECTOMY AT MILITARY HOSPITAL 103

Nguyen Huu Van1,2, Pham Manh Cuong3,4, Lai Ba Thanh3,4, Ho Chi Thanh3,4
1 Military Medical University
2 Học viện Quân y
3 Military Hospital 103
4 Bệnh viện Quân y 103
Corresponding author: hochithanhbv103@gmail.com
DOI: 10.52163/yhc.v64i4.726
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Abstract

Objective: Splenic rupture is a common injury in blunt abdominal trauma, often in the setting of multiple trauma. Clinical and paraclinical evaluation is very important to have the attitude and to choose the treatment method urgently and appropriately for the patient.

Aim: Study clinical and paraclinical characteristics of patients undergoing splenectomy due to trauma.

Subjects and methods: A prospective and cross-sectional study on 65 of blunt splenic patients undergoing Splenectomy at Military Hospital 103 from January 2019 to June 2023.

Results: 58 patients with traumatic splenic rupture undergoing Splenectomy, the mean age was: 30.6±13.049 years old, the youngest was 7 years old, and the oldest was 67 years old. Patients of working age were 87.9%, male ratio was 77.6%, and traffic accidents were 70.7%. There was 32.8% of isolated blunt splenic injury, 48.3% of the patients admitted to the hospital in shock, the rate of not receiving first aid before the hospital was 53.4%, and the average time to hospital was 4.2. ± 4.402 hours. 100% of the patients received an emergency ultrasound in bed, the rate of abdominal computed tomography with contrast injection was 58.6%, the splenic injury grade on CT was not related to shock with p > 0.05.

Conclusion: Spleen ruptured abdominal trauma was common in working age. The common cause was traffic accidents, mostly multiple traumas, patients did not receive first aid before the hospital, and the shock rate was high.

References
[1]
Girard E, Abba J, Cristiano N et al., Management Google Scholar
[2]
of splenic and pancreatic trauma, J Visc Surg, Google Scholar
[3]
(4), 45-60, 2016. Google Scholar
[4]
Rowell SE, Biffl WL, Brasel K et al., Western Google Scholar
[5]
Trauma Association Critical Decisions in Google Scholar
[6]
Trauma: Management of adult blunt splenic Google Scholar
[7]
trauma-2016 updates, J Trauma Acute Care Google Scholar
[8]
Surg, 82(4), 787-793, 2017. Google Scholar
[9]
Coccolini F, Montori G, Catena F et al., Splenic Google Scholar
[10]
trauma: WSES classification and guidelines Google Scholar
[11]
for adult and pediatric patients, World J Emerg Google Scholar
[12]
Surg, 12, 40, 2017. Google Scholar
[13]
Fransvea P, Costa G, Massa G et al., Nonoperative Google Scholar
[14]
management of blunt splenic injury: is it really Google Scholar
[15]
so extensively feasible? a critical appraisal of a Google Scholar
[16]
single-center experience, Pan AfrMed J, 32, 2019. Google Scholar
[17]
Kozar RA, Crandall M, Shanmuganathan K et Google Scholar
[18]
al., Organ injury scaling 2018 update: Spleen, Google Scholar
[19]
liver, and kidney, J Trauma Acute Care Surg. Google Scholar
[20]
(6), 1119-1122, 2018. Google Scholar
[21]
Trần Ngọc Dũng, Nghiên cứu điều trị không mổ Google Scholar
[22]
vỡ lách trong chấn thương bụng kín tại Bệnh Google Scholar
[23]
viện Hữu nghị Việt Đức, Luận án tiến sĩ y học, Google Scholar
[24]
Trường Đại học Y Hà Nội, 2019. Google Scholar
[25]
Trần Văn Đáng, Nghiên cứu chỉ định và kết quả Google Scholar
[26]
điều trị bảo tồn vỡ lách do chấn thương bụng kín Google Scholar
[27]
tại Bệnh viện đa khoa tỉnh Bình Dương, Luận án Google Scholar
[28]
tiến sĩ Y học, Học viện Quân y, Hà Nội, 2010. Google Scholar
[29]
Mader MM, Lefering R, Westphal M et al., Google Scholar
[30]
Traumatic brain injury with concomitant injury Google Scholar
[31]
to the spleen: characteristics and mortality of a Google Scholar
[32]
high-risk trauma cohort from the TraumaRegister Google Scholar
[33]
DGU®, Eur J Trauma Emerg Surg, 48(6), 4451- Google Scholar
[34]
[35]
Lê Tư Hoàng, Nghiên cứu ứng dụng nội soi ổ Google Scholar
[36]
bụng trong chẩn đoán và điều trị chấn thương Google Scholar
[37]
bụng kín, Luấn án Tiến sĩ y học, Trường Đại học Google Scholar
[38]
Y Hà Nội, 2009. Google Scholar
[39]
Planquart F, Marcaggi E, Blondonnet R et al., Google Scholar
[40]
Appropriateness of Initial Course of Action Google Scholar
[41]
in the Management of Blunt Trauma Based on Google Scholar
[42]
a Diagnostic Workup Including an Extended Google Scholar
[43]
Ultrasonography Scan, JAMA Netw Open. Google Scholar
[44]
(12), e2245432, 2022. Google Scholar
[45]
Fleming S, Bird R, Ratnasingham K et al., Google Scholar
[46]
Accuracy of FAST scan in blunt abdominal Google Scholar
[47]
trauma in a major London trauma centre, Int J Google Scholar
[48]
Surg, 10(9), 2012. Google Scholar
[49]
Requarth JA, D'Agostino RB Jr, Miller PR, Google Scholar
[50]
Nonoperative management of adult blunt Google Scholar
[51]
splenic injury with and without splenic artery Google Scholar
[52]
embolotherapy: a meta-analysis, J Trauma. Google Scholar
[53]
(4), 898-903, 2011. Google Scholar