Freiwald Sandra
Perm J. 2010 Summer;14(2):41-4. doi: 10.7812/TPP/09-101.
Since the 1970s, the management of blunt splenic trauma has evolved from almost exclusive surgical management to selective use of nonsurgical management in hemodynamically stable patients. Understanding of the spleen's immunologic importance in protection against overwhelming postsplenectomy infection led to development first of surgical techniques for splenic salvage and later to protocols for nonsurgical management of adults with blunt splenic injury. The evolution of nonsurgical management has resulted in new patterns of postsplenic trauma complications.This article describes a pancreatic pseudocyst, one of several described delayed complications of nonsurgical management of blunt splenic trauma. Along with missed splenic injury and delayed rupture, the development of a splenic pseudocyst represents challenges for any multidisciplinary team involved in trauma care. Detection and management of these complications is discussed, as is postsplenectomy vaccination and return to activity.
自20世纪70年代以来，钝性脾外伤的管理已从几乎完全采用手术治疗演变为对血流动力学稳定的患者选择性地使用非手术治疗。对脾脏在预防脾切除术后暴发性感染中的免疫重要性的认识，首先促成了脾挽救手术技术的发展，随后又促成了钝性脾损伤成人患者非手术治疗方案的制定。非手术治疗的演变导致了脾外伤后并发症的新模式。本文描述了胰腺假性囊肿，它是钝性脾外伤非手术治疗所描述的几种延迟并发症之一。除了漏诊脾损伤和延迟破裂外，脾假性囊肿的形成对任何参与创伤护理的多学科团队来说都是挑战。本文讨论了这些并发症的检测和管理，以及脾切除术后的疫苗接种和恢复活动情况。
