Department of Surgery, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), Ebonyi State, Nigeria.
Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
Afr Health Sci. 2023 Mar;23(1):785-794. doi: 10.4314/ahs.v23i1.83.
Splenic trauma has been recognized as the most common cause of preventable deaths amongst trauma patients. Due to paucity of modern diagnostic imaging facilities in our setting, determination of the error rates and role of the simple, available diagnostic approaches are worthwhile and relevant to the practice of general surgery.
The aim was to determine the role and diagnostic accuracy of clinical and sonographic assessments of splenic injuries.
This was a prospective study of the value of pre-operative clinical and sonographic assessments of patients with splenic injuries in our setting.
A total of 111 patients with abdominal trauma were evaluated. Of these, splenic injuries were confirmed in 75 patients intra-operatively, mainly from blunt trauma. Of the 97 cases diagnosed by clinical method, 66(68.0%) were confirmed by intraoperative findings. Similarly, of 86 sonographic diagnoses of splenic injuries, 61 (70.9%) truly had splenic trauma. Sensitivity for sonographic and clinical assessments was 84.7% and 78.9% respectively. False positive and negative rates for clinical (27.3% versus 44.1%) and ultrasonographic (29.1% versus 40.0%) assessments were high.
Majority of splenic injuries were due to blunt abdominal trauma. The two diagnostic methods showed high sensitivity, but performed poorly for other validity tests.
脾脏创伤已被认为是创伤患者中可预防死亡的最常见原因。由于我们所处的环境缺乏现代诊断成像设施，因此确定错误率和简单、可用的诊断方法的作用与普通外科实践相关且有价值。
旨在确定临床和超声评估脾脏损伤的作用和诊断准确性。
这是一项关于术前临床和超声评估脾脏损伤患者的价值的前瞻性研究。
共评估了 111 例腹部创伤患者。其中，75 例患者术中证实有脾脏损伤，主要来自钝性创伤。97 例临床诊断为脾损伤的病例中，66 例（68.0%）通过术中发现证实。同样，86 例超声诊断脾损伤中，61 例（70.9%）确实存在脾损伤。超声和临床评估的敏感性分别为 84.7%和 78.9%。临床（27.3%对 44.1%）和超声（29.1%对 40.0%）评估的假阳性和假阴性率较高。
大多数脾损伤是由钝性腹部创伤引起的。这两种诊断方法的敏感性都很高，但在其他有效性测试中表现不佳。
