We have located links that may give you full text access.
Nonoperative treatment of adult splenic trauma: development of a computed tomographic scoring system that detects appropriate candidates for expectant management.
Journal of Trauma 1988 June
We reviewed the charts of 87 patients with documented splenic injuries resulting from blunt trauma admitted to a regional trauma referral center during the 32-month period beginning in January 1984. Delayed celiotomy was defined as surgical intervention for splenic injury after a trail of nonoperative management lasting at least 24 hours. Delayed celiotomy was not required in any of the 16 cases in the pediatric age group (age less than or equal to 17 years) who were initially managed nonoperatively. In contrast, of the 27 adults who were initially treated nonoperatively, ten (37%) ultimately required celiotomy. Although splenorrhaphy was successfully performed in 21 of 44 patients undergoing early operation, all ten of the patients requiring celiotomy after an unsuccessful trial of observation underwent splenectomy rather than a spleen-preserving procedure. Of the 27 adults who were initially managed nonoperatively, 24 had abdominal computed tomography (CT) performed during their initial diagnostic evaluation. Twenty-three of these scans were reviewed by one of the authors. A CT scoring system was developed, based on the degree of splenic parenchymal and capsular injury and the amount of fluid in the abdomen and the pelvis. Adult patients who were successfully treated without operation had a significantly (p = 0.011) lower total CT score than did patients who required delayed celiotomy. No adult with a total CT score less than 2.5 required delayed operative intervention. These data support
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app