Open AccessDvovremensko krvarenje kod bolesnika sa povredom slezine
Author(s) -
B Stefanović,
P Aleksandar Karamarkovic,
Zlatibor Lončar,
Sladjana Mijatovic,
Vasilije Jeremić,
Predrag Savic
Publication year - 2002
Publication title -
acta chirurgica iugoslavica
Language(s) - English
Resource type - Journals
eISSN - 2406-0887
pISSN - 0354-950X
DOI - 10.2298/aci0203055s
Subject(s) - medicine , polytrauma , etiology , shock (circulatory) , occult , blunt , surgery , spleen , hemodynamics , hemorrhagic shock , hematoma , lesion , anesthesia , alternative medicine , pathology
Although the diagnosis of spleen injuries is not a considerable clinical problem today, subsequent ruptures of this organ may occur in a smaller number of patients (2-5% of total proportion of spleen injuries) following the so-called "free interval". Such injuries are most commonly explained by present hematoma localized in the central spleen, which becomes larger in time, and eventually causes its rupture. This form of lesion may be found both in isolated blunt abdominal injuries and in associated injuries. When it is the question of delayed hemorrhage, our results as well as data obtained from foreign literature, suggest three basic rise factors of the etiology of this type of injury. These are as follows: a) spleen injuries in severe trauma or polytrauma, b) older patients (over 65 years of age), and c) in cases when more than a single blood unit had to be administered for the initial hemodynamic stabilization of a patient. Delayed hemorrhage, which is occult in polytraumatized patients since it is frequently "disguised" by severity of clinical picture and traumatic shock, may subsequently cause sudden fall of hemogram and hemodynamic parameter values, and if immediate surgery is not performed, it may lead to heavy bleeding and lethal outcome of the patient.