Background & Aims : Recognition of the importance of splenic immune function has prompted the surgeons to preserve the upper part of the spleen on the base of short gastric vessels after splenic trauma. This study aims at evaluating the function of upper pole of spleen in patients with traumatic injury to the spleen.

  Materials & Methods : In a clinical trial, 30 patients with traumatic injury to the spleen were evaluated in Tabriz Imam Hospital. They were categorized in 3 ten-patient groups: controls that treated conservatively, cases with preservation of the upper pole of spleen, and the group underwent total splenectomy. Duration of hospital stay and in-hospital complications, as well as the blood peripheral smear and serum levels of IgG and IgM, 3 months after discharge was compared between the groups.

  Results : No major complications or need of reoperation were documented in any patient during hospital stay. In radioscintigraphy of the remnant spleen in the cases group after 3 months, all the cases were functional. Mean serum level of IgM was significantly lower in the total splenectomy group comparing with the controls. However, the mean serum level of IgG was not significantly different between the groups. Abnormal morphology of red blood cells in the peripheral smear was significantly more frequent in the total splenectomy group comparing with the other two groups.

  Conclusion : According to our results, subtotal splenectomy with saving the upper pole along with the short gastric vessels is superior to the total splenectomy in managing the traumatic spleen injuries.  

  Source : Urmia Med J 2011: 21 (5):447 ISSN: 1027-3727