Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Splenic surgery is common surgical procedure with different indications and approaches that carries some potential complications which can be avoided.
OBJECTIVE:
To analyze the indications, management and complications of splenic surgery.
PATIENTS AND METHOD:
Prospective study conducted in the 3rd unit of general surgery department of Baghdad teaching hospital & private hospital over a period of 3 years, from the first of January 2008 till the end of December 2011. Ninety six patients with traumatic and non traumatic splenic pathologies were evaluated and followed up.
RESULTS:
This study includes ninety six patients with different splenic pathologies were included in this study with mean age of 23.69 ± 14.853 years. Sixty five patients with non traumatic pathology were treated by elective surgery with mean age of 20.25 ± 12.857 years, fifty eight of them by open splenectomy, four by laparoscopic splenectomy, two cystectomy of hydatid disease of the spleen and one by drainage of splenic abscess. Idiopathic thrombocytopenic purpura (I.T.P.) was the most common indication of non-traumatic splenectomy followed by thalassemia. Thirty one patients with trauma with mean age of 30.90 ± 16.325 years (16 of them had penetrating injury and 15 had blunt trauma) were treated by emergency splenectomy in 24 patients, splenorrhaphy in 5 and conservative treatment in 2 of them. Post-operative complications occurred in 25(26%) patients, pulmonary complication was the most common one, and the overall mortality was 5.2%.
CONCLUSION:
Splenectomy still the most common option in traumatic cases but the availability of new diagnostic imaging might improve the future results to conserve some injured spleen and there is a place for laparoscopic approach in selected cases of elective splenectomy and splenic preservation in some splenic hydatid cyst.