SURGICAL MANAGEMENT OF SPLENIC TRAUMA
Abdel-Wahab Hassan Mohammed;
Abstract
Splenorrhaphy and non- operative management of splenic injuries has now become routine aspects in the management of splenic trauma. Unfortunately, not all splenic injuries are
readily amenable to conventional spleen conservmg approaches.
Heterotopic splenic autotransplantation has been advocated for patients with severe grade IV and injuries that would otherwise mandate splenectomy. For this subset of patients, splenic salvage by autotransplantation would theoretically preserve the critical role the spleen plays in the host's defense against infection.
After splenectomy, patients have an increased risk of overwhelming infection or sepsis involving encapsulated bacteria such as pneumococci. The value of human spleen autotransplantation after splenectomy because of trauma has long been question. Mononuclear phagocyte system function appeared to be similar to that in splenectomized persons. The presence of specific antipneumococcal antibodies would allow other parts of the mononuclear phagocyte system, such as those in the liver, to phagocytes opsonized bacteria.
In the past two decades have witnessed significant progress in the management of patients with splenic injuries. There has been a gradual appreciation of the definite relationship between the asplenic state & the development of postsplenectomy sepsis. The spleen is no longer considered a superfluous organ, & its complex roles in cellular & humeral immunity are slowly being understood. This has fostered a
readily amenable to conventional spleen conservmg approaches.
Heterotopic splenic autotransplantation has been advocated for patients with severe grade IV and injuries that would otherwise mandate splenectomy. For this subset of patients, splenic salvage by autotransplantation would theoretically preserve the critical role the spleen plays in the host's defense against infection.
After splenectomy, patients have an increased risk of overwhelming infection or sepsis involving encapsulated bacteria such as pneumococci. The value of human spleen autotransplantation after splenectomy because of trauma has long been question. Mononuclear phagocyte system function appeared to be similar to that in splenectomized persons. The presence of specific antipneumococcal antibodies would allow other parts of the mononuclear phagocyte system, such as those in the liver, to phagocytes opsonized bacteria.
In the past two decades have witnessed significant progress in the management of patients with splenic injuries. There has been a gradual appreciation of the definite relationship between the asplenic state & the development of postsplenectomy sepsis. The spleen is no longer considered a superfluous organ, & its complex roles in cellular & humeral immunity are slowly being understood. This has fostered a
Other data
| Title | SURGICAL MANAGEMENT OF SPLENIC TRAUMA | Other Titles | العلاج الجراحى لاصابات الطحال | Authors | Abdel-Wahab Hassan Mohammed | Issue Date | 2001 |
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