Bhishman T, Arooran K, Umesh J, Mayorathan U
Accident and Orthopaedic Service, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Office of the Judicial Medical Officer, Teaching Hospital, Jaffna, Sri Lanka.
Int J Surg Case Rep. 2024 Nov;124:110251. doi: 10.1016/j.ijscr.2024.110251. Epub 2024 Sep 7.
The utilization of laparoscopy in severe splenic injuries following blunt abdominal trauma is limited because of difficulties encountered due to ongoing bleeding, chances of missed injury, and lack of experience.
We report a young male with polytrauma (head injury, haemothorax, femur fracture, Grade V splenic injury) who underwent a successful laparoscopic splenectomy on day 3 following the failure of conservative management of grade V blunt splenic injury involving the hilum.
The utility of laparoscopy in the management of blunt trauma is controversial besides several series have shown acceptable outcomes for both solid organ and visceral injuries in experienced hands. Furthermore, there are several reports describing the utility of the laparoscopic approach for isolated splenic injuries in stable patients.
The utility of the laparoscopic approach for this patient was successful without major challenges during the procedure. The key initial step was achieving complete hemostasis as early as possible.
