Splenic Injury Following Blunt Abdominal Trauma: The Experience from a Regional Referral Hospital in Uganda

Wismayer R

Published on: 2023-04-13

Abstract

A 43-year-old gentleman was admitted to Masaka Regional Referral Hospital after having been involved in a road traffic accident (RTA). On examination his Glasgow coma score was 15, the airway was intact, his chest was clear and his pulse rate was 120 bpm-1 and blood pressure (BP) 90/60 mmHg. He complained of generalised abdominal pain and nausea. Abdominal examination revealed generalised abdominal tenderness, particularly in the upper abdomen. His haemoglobin (Hb) was 9g/dl and a FAST ultrasound scan from the A&E Department showed fluid in the splenorenal angle. The patient was transfused 2 units of blood and was transferred to the emergency operating theatre for an emergency laparotomy. At laparotomy, there was 5 litres of blood intraperitoneally and a grade IV splenic injury involving laceration of hilar and segmental vessels.  A splenectomy was carried out and there were no other associated injuries of the liver or bowel and other intra-abdominal organs were intact. Post-operatively he remained haemodynamically stable and experienced an uneventful postoperative recovery. He was discharged on the fourth post-operative day from the surgical ward.