Splenic Injuries At Nnamdi Azikiwe University Hospital, Nnewi Nigeria - A Seven-Year Review

SUMMARY

Background: The spleen is the commonest intra-abdominal organ injured in blunt trauma among patients who reach hospital alive. In both developed and developing communities, the tendency is now to offer splenic conservation for less severe injuries.

Patients and Methods: A retrospective study of all cases of splenic injury treated by the surgical units at the Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, a third generation teaching hospital in Nigeria was undertaken.

Results: Twenty-five patients (19 males and six females) were treated during the period March 1995 to February 2002. Fourteen of the patients (56.0%) had motor vehicle accidents while nine (36.0%) had falls from heights. Eleven patients (44.0%) had associated injuries of which four were intra-abdominal. Abdominal paracentesis was positive for non-clotting blood in 22 patients (88.0%). The time interval from injury to hospital attendance ranged from half an hour to two months while the interval from presentation to definitive surgery ranged from two hours to 48 hours with a mean of 15 hours. The organ injury scored ranged from Grade 1 (8.0%), Grade 2 (8.0%), Grade 3 (20.0%), Grade 4 (12.0%) to Grade 5 (52.0%). An average of two units of blood were used per patient in the peri-operative period. Only two patients with Grade 1 injury had splenic salvage management.

Conclusion: Efforts to reduce road traffic accidents by governmental agencies and the public should be encouraged. The causes of delay in hospital attendance and in treatment were discussed and appropriate measures recommended. Niger. Med. J. 2003, Vol.44(2):41-45.

KEYWORDS: Splenic injuries, Splenic conservation, Splenic salvage