Spleen trauma is the most common condition in closed abdominal injuries due to traffic accidents, falls or collisions when playing sports, assaulted. Spleen often causes bleeding into the abdominal cavity, the level of bleeding depends on the mechanism of injury and severe severe rupture
There are up to 60% of patients with spleen trauma with no injury accompanied by a spleen vulnerability
The general mortality rate of spleen broken is 10% in the first 48 hours if serious injury is accompanied by a traumatic brain injury and infection, alone the single spleen trauma is only 1%
Causes of Spleen's disease
Due to the lesions on the left side of the body are caused by a blow to the upper abdomen or lower than the left chest, accidents in sports, car accidents. Injury spleen can be broken immediately or in some cases is a few days or a whole week after injury
Spleen broken by the spleen expansion: Originated from the accumulation of blood cells in the spleen, caused by single leukocytes and other infections, liver or blood cancer.
Symptoms of Spleen's disease
The common manifestations of a spleen injury include:
Pain in the upper left part of the abdomen, natural pain or when touching
Patient dizziness, confusion, fainting appears after a left abdominal injury
The upper left abdominal area may have bleeding wounds or no wounds but no bleeding in the abdomen due to spleen rupture
People at risk for Spleen's disease
Spleen trauma occurs when there is a force that has a strong impact on the abdomen on the spleen side or injury in another area, so those who are at high risk are people after the accident. Traffic, violence or injury encountered in sports
In addition to the direct impact from the outside, spleen trauma can be seen in patients with systemic diseases such as infection, liver or blood cells accumulated too much in Spleen due to blood cancer
Prevention of Spleen's disease
After trauma due to traffic accidents, labor accidents or accidents in sports, there are symptoms of abdominal pain-left-left area need to go to the medical facility for searching Comprehensive to detect spleen trauma or other complications for timely treatment and treatment
If you have been diagnosed with extended spleen, it is necessary to avoid activities that can cause broken spleen such as avoiding sports and activities that increase the risk of abdominal trauma. Within a few weeks
Diagnostic measures for Spleen's disease
Patients who enter the hospital on an abdominal injury or multiple injury due to traffic accidents, labor accidents or living. Patients with systemic symptoms - showing shock of blood loss such as:
Skin, pale mucosa, panic face or lethargy, sweating, cold hands and feet
Abdominal pain in the left side of the left ribs, the pain spreads away from the abdomen, spreading
Skin injured area is rubbed, bruising
Balance (+): The full block on the lower side or left hip, knocking on the left flank
Pain in ribs
Abdominal obstacles, pain throughout the abdomen with abdominal wall reaction
Rectal examination with painful douglas
Passion of the abdominal cavity feels painless without pain
Subclinical tests
Blood formula: Red blood cells, HCT decreased, increasing leukocytes
Introductive chest X-ray: The left lash is pushed high, the spleen is large, opens the frame, can see the fractures of the left ribs and expand the peritoneal ribs- The colon is down
Spleen trauma ultrasound is the earliest diagnostic means: seeing fluid in the abdominal cavity in the Morrison compartment and left colon groove, spleen and spleen The ball is bigger than usual, the image of the translation around the spleen, the translation under the bag
CT scanner is the best means to evaluate spleen damage and spleen rupture.
The spleen injury according to AAST (US injury association), 1964 includes 5 levels:
Spleen injury 1 :
Hematoma under the shell is not more than 10% of the surface area
The tear is less than 1cm of depth
Spleen injury 2:
Hematoma under 10-50% of the surface area
There is hematoma in parenchyma, size <5 cm
1-3 cm deep tear but no damage to blood vessels
Spleen injury 3:
Hematoma under the shell of more than 50% of the surface area or hematoma under the shell or broken parenchyma hematoma and is spreading
Hematoma in spleen parenchyma> 5cm or spreading
Tears deeper than 3cm or damage blood vessels
Spleen injury 4:
The tear causes damage to blood vessels of lobes or navel
25% of the spleen has anemia.
Spleen injury 5:
Spleen broken or serious injury to the umbilical vessel
Spleen's disease treatments
There are 3 common treatments today depending on the level of spleen injury
Spleen surgery method
indicated when:
Spleen causes internal bleeding, patients with shock and risk of death
Spleen broken level 5
There are coordinated lesions and infections
Pathological spleen, patients with coagulation disorders
Conservation treatment failure
Spleen conservation surgery method
Spleen when spleen broke level 1,2,3 with simple broken lines
partially cut or sell the spleen in the spleen broken level 3 has a complex broken line and 4
Spleen in dexon
Spleen conservation method without surgery
indicated when the spleen damage is simply, the spleen broke level 1.2 and the patient has the total status, no There are coagulation disorders and few abdominal fluids, patients under 55 years old
monitoring at the emergency room of the Faculty, clinical examination every 4-6 hours, monitor hemoglobin and use CT scanner after 48-72 hours when hemodynamic changes
See also:
Spleen cut due to trauma
Where is the spleen lying and what role does it play?
Spleen: Causes, symptoms, diagnosis and treatment
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