[Blast injury to the spleen and pancreas after a non-penetrating gunshot wound--result after 12 years].

The spleen is the most frequently injured organ in adults who sustain blunt abdominal trauma. The aim is to report on a patient with non-penetrating gunshot traumatic injury to the spleen and pancreas, and to evaluate the result after 12 years A soldier with gunshot wound of the left lateral abdominal wall was admitted to the Military Hospital in Mostar in the year 1993. The patient was hemodynamically unstable and underwent emergency surgery. On wound exploration, there was no abdominal penetration. Because of hemodynamic instability, we decided to perform emergency laparotomy and abdominal exploration. The spleen and distal pancreas were shattered. Splenectomy and hemostasis were performed. The peritoneum was closed and the abdominal wall wound healed secondarily. The patient was in good condition postoperatively. Now, after 12 years, the patient is free from any sequel of the war injury. Blast injury to the spleen can result from non-penetrating abdominal gunshot wounds despite the absence of injury to the peritoneum. In war conditions, the diagnosis and indications are usually based on clinical findings only because special investigations, including ultrasound and CT are not readily available. The management of splenic injury has been rapidly modified over the last decade, with ever more emphasis on splenic salvage and nonoperative management, however, these procedures cannot be performed in war conditions. War injuries to the spleen are life threatening and emergency open splenectomy is the only solution.