ABSTRACT
This chapter discusses the surgical procedures for splenic injury. Splenic injury is the commonest abdominal injury in trauma patients. Signs of rupture include the following: history of blunt force to left upper abdomen or lower chest; left lower rib fractures; patient complaining of pain in the left shoulder tip; evidence of hypovolaemic shock; and evidence of blood loss. In a trauma situation, it is essential that the patient is optimally resuscitated before surgery, and this should continue during the operation. The splenic artery and vein are identified at the hilum, and are individually ligated and divided, taking care not to damage the tail of the pancreas. A suction drain may be placed in the splenic bed, and the wound is closed following lavage and an inspection of all the abdominal contents to ensure that no other injuries are present. Post-splenectomy sepsis is the late complication of splenectomy. Long-term antibiotic prophylaxis is administered to protect against encapsulated micro-organisms.
