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Splenic Injury

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2741. Splenectomy after major trauma: could more spleens be saved? Full Text available with Trip Pro

Splenectomy after major trauma: could more spleens be saved? 12831498 2003 08 20 2008 11 20 0035-8843 85 3 2003 May Annals of the Royal College of Surgeons of England Ann R Coll Surg Engl Splenectomy after major trauma: could more spleens be saved? 221-2 Walsh Mike M Brohi Karim K Cord-Udy Cathy C eng Comment Letter England Ann R Coll Surg Engl 7506860 0035-8843 IM Ann R Coll Surg Engl. 2002 Mar;84(2):106-8 11995746 Child Decision Making Humans Referral and Consultation Spleen injuries surgery

2003 Annals of the Royal College of Surgeons of England

2742. In vivo normobaric oxygen exposure depresses spleen cell in vitro Con A response. Effects of 2-mercaptoethanol and peritoneal cells. Full Text available with Trip Pro

by O2 exposure. In cases where mitogen response was highly depressed, restoration was only partial; in these conditions in vivo O2 injury probably involved both macrophages and splenic T cells. The mechanisms of O2 toxicity have been discussed in terms of free radical generation under hyperoxic conditions. (...) In vivo normobaric oxygen exposure depresses spleen cell in vitro Con A response. Effects of 2-mercaptoethanol and peritoneal cells. Normobaric O2 exposure decreased spleen cell (SC) response to T cell mitogen Con A. 3H-TdR incorporation of SC from O2 exposed mice (O2SC) compared to those of control mice (Air SC) decreased significantly after 72 and 87 h O2 exposure. The dose response kinetics to Con A were identical in O2SC or Air SC. Increasing SC number did not restore the response to Con

1984 Clinical and experimental immunology

2743. Blunt transection of the pancreas treated by distal pancreatectomy, splenic salvage, and hyperalimentation. Full Text available with Trip Pro

Blunt transection of the pancreas treated by distal pancreatectomy, splenic salvage, and hyperalimentation. 6407407 1983 07 29 2018 11 13 0003-4932 198 1 1983 Jul Annals of surgery Ann. Surg. Blunt transection of the pancreas treated by distal pancreatectomy, splenic salvage, and hyperalimentation. 117 Moore E E EE eng Letter United States Ann Surg 0372354 0003-4932 AIM IM Enteral Nutrition Humans Jejunum surgery Pancreas injuries surgery Pancreatectomy Spleen surgery 1983 7 1 1983 7 1 0 1 1983

1983 Annals of Surgery

2744. Hepatic and splenic conservation in trauma. Full Text available with Trip Pro

Hepatic and splenic conservation in trauma. 2926759 1989 05 04 2018 11 13 0141-0768 82 2 1989 Feb Journal of the Royal Society of Medicine J R Soc Med Hepatic and splenic conservation in trauma. 122-3 Reidy J F JF eng Letter England J R Soc Med 7802879 0141-0768 IM Embolization, Therapeutic Hemorrhage therapy Humans Liver injuries Spleen injuries 1989 2 1 1989 2 1 0 1 1989 2 1 0 0 ppublish 2926759 PMC1292019 Arch Surg. 1985 Nov;120(11):1241-9 4051729 Br Med J (Clin Res Ed). 1987 Mar 7;294(6572

1989 Journal of the Royal Society of Medicine

2745. Plasma Gamma Globulin Levels After Splenectomy and Spleen Salvage Full Text available with Trip Pro

Plasma Gamma Globulin Levels After Splenectomy and Spleen Salvage A series of plasma globulin studies was carried out on 108 patients who were operated on for splenic trauma during the last 3 years. The reasons for splenectomy or spleen salvage were; gunshot wounds in 22 patients (20.3%); stab injuries in 10 patients (9.2%) and blunt abdominal trauma in 76 patients (70.3%). Plasma gamma globulin determinations were made on the 8th postoperative day and at 3 months. In the splenectomy group (...) ; plasma gamma globulin determinations demonstrated a significant reduction in serum IgM levels (p less than 0.001) but no significant changes in IgA and IgG levels (p greater than 0.05). No changes were detected in IgA, IgG and IgM levels in the spleen salvage group (p greater than 0.05). We believe that the preservation of the traumatized spleen should be the prime aim of surgeons.

1989 HPB Surgery

2746. Successful transthoracic repair of a ruptured spleen. Full Text available with Trip Pro

Splenic Rupture diagnosis etiology surgery 1988 12 1 1988 12 1 0 1 1988 12 1 0 0 ppublish 3221370 PMC1291891 10.1177/014107688808101219 Ann Thorac Surg. 1978 Sep;26(3):199-203 752289 J Trauma. 1980 Jul;20(7):587-92 7392109 Injury. 1981 May;12(6):480-4 7275292 Br J Surg. 1987 May;74(5):343-5 3297232 Am Surg. 1984 Mar;50(3):143-9 6703525 J Trauma. 1986 May;26(5):438-44 3701892 Br J Surg. 1984 Mar;71(3):173-80 6697116 (...) Successful transthoracic repair of a ruptured spleen. 3221370 1989 03 23 2018 11 13 0141-0768 81 12 1988 Dec Journal of the Royal Society of Medicine J R Soc Med Successful transthoracic repair of a ruptured spleen. 733-4 Davies M M Department of Surgery, Westminster Hospital, London. Law N W NW Johnson C D CD eng Case Reports Journal Article England J R Soc Med 7802879 0141-0768 IM Accidents, Traffic Adult Hernia, Diaphragmatic, Traumatic diagnosis etiology surgery Humans Male Spleen surgery

1988 Journal of the Royal Society of Medicine

2747. Complications of splenic tissue reimplantation. Full Text available with Trip Pro

Complications of splenic tissue reimplantation. Splenic tissue reimplantation employing the omental implantation technique was applied in 23 patients undergoing splenectomy for traumatic or iatrogenic splenic injury. Four complications were encountered after autotransplantation (17.4%). Two of these consisted of small bowel obstruction due to postoperative adhesions and were successfully managed by lysis of the adhesions. The other two complications were aseptic necrosis of the splenic (...) transplants and were treated with ablation of the autolysed transplants. A case of abnormal splenic tissue reimplantation in a male patient with unsuspected myelofibrosis is also discussed. He underwent an emergency laparotomy for rupture of a subcapsular splenic haematoma. It is concluded that splenic tissue implantation in the greater omentum is associated with important early morbidity and this should be taken into account whenever application of the method is considered.

1991 Annals of the Royal College of Surgeons of England

2748. Splenic trauma. Choice of management. Full Text available with Trip Pro

the splenic hilum and with the severely shattered spleen; these patients usually are treated best by early operative intervention. Following splenectomy for injury, polyvalent pneumococcal vaccine decreases the likelihood of OPSI and should be used routinely. The role of prophylactic penicillin is uncertain but the use of antibiotics for minor infectious problems is indicated after splenectomy. (...) Splenic trauma. Choice of management. The modern era for splenic surgery for injury began in 1892 when Riegner reported a splenectomy in a 14-year-old construction worker who fell from a height and presented with abdominal pain, distension, tachycardia, and oliguria. This report set the stage for routine splenectomy, which was performed for all splenic injury in the next two generations. Despite early reports by Pearce and by Morris and Bullock that splenectomy in animals caused impaired

1991 Annals of Surgery

2749. Splenic capping: an experimental study of a new technique for splenorrhaphy using woven polyglycolic acid mesh. Full Text available with Trip Pro

Splenic capping: an experimental study of a new technique for splenorrhaphy using woven polyglycolic acid mesh. The use of polyglycolic acid (PGA) stretchable mesh applied to the experimentally injured canine spleen can achieve satisfactory immediate hemostasis by tamponade and simplifies the use of sutures to control remaining areas of hemorrhage. PGA mesh with 1/4" and 1/8" openings was utilized for splenorrhaphy in 12 adult mongrel dogs subjected to sharp splenic trauma. By gross (...) and histologic examination, the PGA mesh material appears to undergo progressive absorption to complete absorption by 85 days. For the 12 animals and 30 operative procedures the only complications of the use of the mesh were the occurrence of an intrasplenic seroma in a single animal at 6 weeks after operation and three wound infections. With this material, rapid, simple canine splenic injury repair can be achieved. PGA mesh further assists in the healing process, and in maintaining maximum splenic

1982 Annals of Surgery

2750. Autologous splenic transplantation. Full Text available with Trip Pro

Autologous splenic transplantation. 8147603 1994 04 29 2018 11 13 0003-4932 219 3 1994 Mar Annals of surgery Ann. Surg. Autologous splenic transplantation. 223-4 Martin L W LW eng Editorial United States Ann Surg 0372354 0003-4932 AIM IM Humans Infection immunology Spleen immunology injuries transplantation Splenectomy adverse effects 1994 3 1 1994 3 1 0 1 1994 3 1 0 0 ppublish 8147603 PMC1243129 Ann Surg. 1952 Aug;136(2):239-42 14953147

1994 Annals of Surgery

2751. Blunt transection of the pancrease treated by distal pancreatectomy, splenic salvage and hyperalimentation. Four cases and review of the literature. Full Text available with Trip Pro

Blunt transection of the pancrease treated by distal pancreatectomy, splenic salvage and hyperalimentation. Four cases and review of the literature. The increasing awareness among surgeons of overwhelming postsplenectomy sepsis has led to new and innovative procedures to save the spleen. In pancreatic transection injuries (Type II)26 the classical treatment has been distal pancreatectomy and splenectomy. The opportunity to treat several patients with pancreatic transections sustained during (...) blunt abdominal trauma lead to the review of the literature on the subject. Particular attention was paid to treatment of these injuries during distal pancreatectomy with splenic salvage, appropriate drainage, and hyperalimentation. Associated complications were likewise investigated and reviewed.

1982 Annals of Surgery

2752. Delayed rupture of the spleen in rheumatoid arthritis. Full Text available with Trip Pro

Delayed rupture of the spleen in rheumatoid arthritis. When tripping and falling patients with rheumatoid arthritis may adopt the 'fetal tuck' position to protect their painful deformed hands. There is then a risk of splenic injury by the left elbow, which may not be immediately apparent.

1990 Annals of the Rheumatic Diseases

2753. Trauma to the spleen. Full Text available with Trip Pro

Trauma to the spleen. 2514699 1990 03 15 2018 11 13 0264-4924 6 4 1989 Dec Archives of emergency medicine Arch Emerg Med Trauma to the spleen. 237-40 Gough D C DC Royal Manchester Children's Hospital, Pendlebury, England. eng Journal Article England Arch Emerg Med 8500828 0264-4924 IM Adult Child Humans Infection Control Postoperative Complications prevention & control Spleen injuries Splenectomy Vaccination Wounds, Nonpenetrating diagnosis surgery 1989 12 1 1989 12 1 0 1 1989 12 1 0 0 ppublish (...) 2514699 PMC1285621 Am J Surg. 1985 Jun;149(6):716-21 4014547 Surg Gynecol Obstet. 1982 Aug;155(2):257-64 7048593 JAMA. 1982 Sep 3;248(9):1104-7 7109207 N Engl J Med. 1986 Jun 19;314(25):1593-9 3086721 Surgery. 1984 Jan;95(1):6-13 6606857 J Trauma. 1988 Jun;28(6):828-31 3385827 J Trauma. 1988 Jan;28(1):24-34 3339660 Br J Surg. 1987 May;74(5):350-2 3594120 Arch Surg. 1982 Sep;117(9):1147-50 7115061 Ann Surg. 1982 Feb;195(2):172-6 7055394 Injury. 1985 Jan;16(4):221-6 3967901 Ann Surg. 1984 Dec;200(6):702

1989 Archives of Emergency Medicine

2754. Nonoperative management of adult blunt splenic trauma. Criteria for successful outcome. Full Text available with Trip Pro

Nonoperative management of adult blunt splenic trauma. Criteria for successful outcome. Nonoperative management of blunt splenic trauma in adults is controversial despite numerous reports advocating this mode of therapy. Blunt splenic trauma is frequently managed without operation at our institution and, to define criteria that may predict a successful outcome, a retrospective review (1980 to 1988) of all adult splenic injuries was undertaken. Splenic injuries were documented by scintillation (...) studies, CAT scanning, or at laparotomy. Sixty of 252 (24%) splenic injuries were initially treated without operation, which included bed rest, ICU monitoring, frequent physical exams, nasogastric tube, serial hematocrits, and follow-up splenic imaging. Five patients (5 of 60) failed nonoperative management and required interval laparotomy. Reasons for failure included blood loss greater than four units, enlarging splenic defect, or increasing peritoneal signs. Parameters predicting a successful

1989 Annals of Surgery

2755. Splenic trauma, choice of management. Full Text available with Trip Pro

Splenic trauma, choice of management. 1571044 1992 02 18 2008 11 20 0003-4932 215 1 1992 Jan Annals of surgery Ann. Surg. Splenic trauma, choice of management. 92-3 Simons R R eng Case Reports Comment Letter United States Ann Surg 0372354 0003-4932 AIM IM Ann Surg. 1991 Feb;213(2):98-112 1992948 Child Female Humans Spleen injuries surgery Splenectomy methods 1992 1 1 1992 1 1 0 1 1992 1 1 0 0 ppublish 1571044 PMC1242389

1992 Annals of Surgery

2756. Non-operative management of a splenic laceration in a patient with the Proteus syndrome. Full Text available with Trip Pro

, a non-operative approach was preferred despite considerable transfusion requirement, and the patient successfully underwent embolisation of the splenic artery. This is the first reported case of splenic injury in a patient with Proteus syndrome. (...) Non-operative management of a splenic laceration in a patient with the Proteus syndrome. An adult patient with the Proteus syndrome sustained a grade III splenic laceration after falling off a horse. Clinical features of this rare disorder include subcutaneous and visceral hamartomatous tumours. The patient also suffered from chronic intravascular coagulation associated with extensive haemangiomatosis (Kasabach-Merritt syndrome). Considering the visceral anomalies and abnormal coagulation

1997 Journal of accident & emergency medicine

2757. Use of abdominal ultrasonography to assess pediatric splenic trauma. Potential pitfalls in the diagnosis. Full Text available with Trip Pro

abdominal trauma who were diagnosed with splenic injury by computerized tomography (CT) scan prospectively were enlisted in this study. Degree of splenic injury was evaluated by both CT and US. The ultrasounds were evaluated by an initial reading as well as by a radiologist who was blinded as to the results of the CT.Twelve (38%) of the 32 splenic injuries found on CT were missed completely on the initial reading of the US. When the ultrasounds were graded in a blinded fashion, 10 (31%) of the splenic (...) lacerations were missed and 17 (53%) were downgraded. Seven (22%) of the 32 splenic fractures were not associated with any free intraperitoneal fluid on the CT scan.This study has shown that US has a low level of sensitivity (62% to 78%) in detecting splenic injury and downgrades the degree of injury in the majority of cases. Reliance on free intraperitoneal fluid may be inaccurate because not all patients with splenic injury have free intra-abdominal fluid. Based on these findings, US may be of limited

1997 Annals of Surgery

2758. Changing patterns in the management of splenic trauma: the impact of nonoperative management. Full Text available with Trip Pro

injuries. This report describes changing patterns of therapy in 190 consecutive patients with splenic injuries seen during a subsequent 6-year period (1990 to 1996). An algorithmic approach for patient management and pitfalls to be avoided to ensure safe nonoperative management are detailed.Nonoperative management criteria included hemodynamic stability and computed tomographic examination without shattered spleen or other injuries requiring celiotomy.Of 190 consecutive patients, 102 (54%) were managed (...) nonoperatively: 96 (65%) of 147 patients with blunt splenic injuries, which included 15 patients with intrinsic splenic pathology, and 6 hemodynamically stable patients with isolated stab wounds (24% of all splenic stab wounds). Fifty-six patients underwent splenectomy (29%) and 32 splenorrhaphy (17%). The mean transfusion requirement was 6 units for splenectomy survivors and 0.8 units for nonoperative therapy (85% received no transfusions). Fifteen of the 16 major infectious complications that occurred

1998 Annals of Surgery

2759. A new spleen-preserving technique using radiofrequency ablation technology. (Abstract)

A new spleen-preserving technique using radiofrequency ablation technology. Splenic salvage is the ultimate goal of the treatment for splenic injury. We experimentally investigated a spleen salvage technique after spleen injury using radiofrequency ablation technology.A grade IV spleen trauma was produced in 10 white male Landrace pigs (the lower pole of the spleen was sharply divided at the level where the lower hilar vessel enters the organ) under general anesthesia. A Radionics Cooltip Radio (...) may be used in splenic injury to stop bleeding, especially when blood transfusion or surgery is indicated. This procedure may reduce the frequency of open surgery for repair of the injury, the number of splenectomies, and the amount of blood transfusion required. The advantage of use under ultrasound or computed tomographic guidance or laparoscopically makes it even more appealing. Thus, we suggest that further study in human subjects is required to validate our results.

2004 Journal of Trauma

2760. Radiographic characteristics of postinjury splenic autotransplantation: avoiding a diagnostic dilemma. (Abstract)

. In the past, one of our patients underwent percutaneous drainage of such collections that were sterile, and one patient required operative evacuation of infected implants. The purpose of this study was to determine whether there is a characteristic radiographic appearance of splenic implants, whether this appearance changes with time, and whether implants can be differentiated from abdominal abscesses.Patients at our Level I trauma center who underwent operative therapy for splenic injury from January (...) 1995 to May 2002 were identified using our trauma registry. Charts were reviewed and CT scans read in a blinded fashion by a radiologist.During the study period, 505 patients were admitted for splenic trauma. One hundred forty-five patients (29%) required operative intervention for splenic injuries. Splenorrhaphy was performed in 27 patients and splenectomy was required in 118 patients. Twenty-three patients had splenic autotransplantation into the omentum, of whom 11 underwent postoperative CT

2004 Journal of Trauma

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