One hundred consecutive splenectomies for trauma: is histologic evaluation really necessary?

The Journal of Trauma
G Peter FakhreMatthew W Lube

Abstract

Splenectomy remains the most commonly performed abdominal operation for trauma. Although the vast majority of these patients (pts) are young and healthy, histologic evaluation is still routinely performed. We propose that routine histologic sampling of an injured yet otherwise grossly normal spleen is unnecessary. A retrospective review of 100 consecutive pathologic specimens of pts undergoing splenectomy for trauma at a Level I trauma center was performed during a 25-month period. Data are reported as mean +/- SD. Average age was 34.4 +/- 15.1 years. There were 78 men and 22 women. Average injury severity score was 28.3 +/- 12.9. The most common mechanisms of injury were motor vehicle collisions (56%) and motorcycle collisions (15%). Average length of stay was 17.4 +/- 19 days. Microscopic pathologic findings returned as benign with no evidence for neoplasia in 99 of 100 specimens. Mean specimen weight was 184.6 +/- 188.7 g. Only one spleen, which appeared grossly abnormal and weighed 1,800 g, had abnormal histology demonstrating extramedullary hematopoiesis. This pt died before further workup. Our review suggests that the routine microscopic evaluation of spleens removed after traumatic injury, as is currently the standard of...Continue Reading

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May 8, 2003·Journal of the American Academy of Dermatology·María Jesus Fernández AceñeroJavier Peñalver
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Citations

Feb 11, 2010·World Journal of Surgery·Ryan GertzDaniel R Margulies
Jan 1, 2014·Forensic Science International : Synergy·Irene RiezzoVittorio Fineschi
Jul 12, 2018·Revista do Colégio Brasileiro de Cirurgiões·Daniel Linhares CardosoAntônio José Grande
Feb 6, 2015·BMJ Open·Shunichiro NakaoUNKNOWN Japanese Emergency Medicine Network Investigators
Nov 25, 2020·The American Surgeon·Robert A GonzalezRoxie M Albrecht
Nov 27, 2021·ANZ Journal of Surgery·Amr BadawyIslam A El-Sayes

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