Minimally invasive splenectomy in grade IV splenic trauma: A case report associated with high-grade renal trauma
Introduction and importance: In closed abdominal trauma, the spleen is the most frequently injured organ (30–45%). Splenic lesions grades IV-V have higher failure rates with nonoperative management (NOM). The minimally invasive approach is an alternative when NOM fails. This is the first reported ca...
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| Lenguaje: | Español |
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Elsevier Ltd
2021
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| Acceso en línea: | http://pa.bibdigital.ucc.edu.ar/3476/1/A_Pantoja%20Pachajoa_Palacios%20Huantuco_Bruera.pdf |
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I38-R144-34762025-05-07T12:30:54Z http://pa.bibdigital.ucc.edu.ar/3476/ Minimally invasive splenectomy in grade IV splenic trauma: A case report associated with high-grade renal trauma Pantoja Pachajoa, Diana A. Palacios Huatuco, René M. Bruera, Nicolás Llahi, Florencia Doniquian, Marcelo Alejandro R Medicina (General) Introduction and importance: In closed abdominal trauma, the spleen is the most frequently injured organ (30–45%). Splenic lesions grades IV-V have higher failure rates with nonoperative management (NOM). The minimally invasive approach is an alternative when NOM fails. This is the first reported case of a patient with splenic and left renal trauma, both grade IV, with combined management, which consisted of a minimally invasive surgical resolution of the splenic trauma and a conservative management of the renal trauma, with a satisfactory recovery of the patient. This contributes to understanding the benefits of minimally invasive surgery in moderate splenic trauma associated with other high-grade injuries. Case presentation: We present a 45-year-old woman with a multiple trauma after a motorbike vs car traffic accident. On physical examination, she was hemodynamically stable, with abdominal guarding and generalized rebound tenderness associated with multiple upper and lower limb fractures. An abdominal CT scan revealed grade IV splenic and left renal trauma, with moderate hemoperitoneum. A minimally invasive laparoscopic approach for hemoperitoneum drainage and splenectomy was performed. Clinical discussion: There is currently no consensus to define the indications for minimally invasive treatment on splenic trauma. While laparotomy is the standard treatment, it is not without potential severe complications, while laparoscopy providing a treatment option in selected cases with hemodynamic stability. Conclusion: The role of the minimally invasive approach is safe and feasible in selected patients with high-grade splenic lesions and hemodynamic stability, including the association with other organic lesions such as kidney trauma Elsevier Ltd 2021-02 info:eu-repo/semantics/article info:eu-repo/semantics/closedAccess application/pdf spa http://pa.bibdigital.ucc.edu.ar/3476/1/A_Pantoja%20Pachajoa_Palacios%20Huantuco_Bruera.pdf Pantoja Pachajoa, Diana A. ORCID: https://orcid.org/0000-0002-3968-4206 <https://orcid.org/0000-0002-3968-4206>, Palacios Huatuco, René M., Bruera, Nicolás, Llahi, Florencia and Doniquian, Marcelo Alejandro ORCID: https://orcid.org/0000-0002-6670-9253 <https://orcid.org/0000-0002-6670-9253> (2021) Minimally invasive splenectomy in grade IV splenic trauma: A case report associated with high-grade renal trauma. International Journal of Surgery Case Reports, 79. ISSN 2210-2612 https://www.scopus.com/redirect/linking.uri?targetURL=https%3a%2f%2fdoi.org%2f10.1016%2fj.ijscr.2020.12.077&locationID=1&categoryID=4&eid=2-s2.0-85098941003&issn=22102612&linkType=ViewAtPublisher&year=2021&origin=recordpage&dig=e9819b7b67cc19aad24d3e0c7dd5c1b4 info:eu-repo/semantics/altIdentifier/doi/10.1016/j.ijscr.2020.12.077 |
| institution |
Universidad Católica de Córdoba |
| institution_str |
I-38 |
| repository_str |
R-144 |
| collection |
Producción Académica Universidad Católica de Córdoba (UCCor) |
| language |
Español |
| orig_language_str_mv |
spa |
| topic |
R Medicina (General) |
| spellingShingle |
R Medicina (General) Pantoja Pachajoa, Diana A. Palacios Huatuco, René M. Bruera, Nicolás Llahi, Florencia Doniquian, Marcelo Alejandro Minimally invasive splenectomy in grade IV splenic trauma: A case report associated with high-grade renal trauma |
| topic_facet |
R Medicina (General) |
| description |
Introduction and importance: In closed abdominal trauma, the spleen is the most frequently injured organ (30–45%). Splenic lesions grades IV-V have higher failure rates with nonoperative management (NOM). The minimally invasive approach is an alternative when NOM fails. This is the first reported case of a patient with splenic and left renal trauma, both grade IV, with combined management, which consisted of a minimally invasive surgical resolution of the splenic trauma and a conservative management of the renal trauma, with a satisfactory recovery of the patient. This contributes to understanding the benefits of minimally invasive surgery in moderate splenic trauma associated with other high-grade injuries. Case presentation: We present a 45-year-old woman with a multiple trauma after a motorbike vs car traffic accident. On physical examination, she was hemodynamically stable, with abdominal guarding and generalized rebound tenderness associated with multiple upper and lower limb fractures. An abdominal CT scan revealed grade IV splenic and left renal trauma, with moderate hemoperitoneum. A minimally invasive laparoscopic approach for hemoperitoneum drainage and splenectomy was performed. Clinical discussion: There is currently no consensus to define the indications for minimally invasive treatment on splenic trauma. While laparotomy is the standard treatment, it is not without potential severe complications, while laparoscopy providing a treatment option in selected cases with hemodynamic stability. Conclusion: The role of the minimally invasive approach is safe and feasible in selected patients with high-grade splenic lesions and hemodynamic stability, including the association with other organic lesions such as kidney trauma |
| format |
Artículo |
| author |
Pantoja Pachajoa, Diana A. Palacios Huatuco, René M. Bruera, Nicolás Llahi, Florencia Doniquian, Marcelo Alejandro |
| author_facet |
Pantoja Pachajoa, Diana A. Palacios Huatuco, René M. Bruera, Nicolás Llahi, Florencia Doniquian, Marcelo Alejandro |
| author_sort |
Pantoja Pachajoa, Diana A. |
| title |
Minimally invasive splenectomy in grade IV splenic trauma: A case report associated with high-grade renal trauma |
| title_short |
Minimally invasive splenectomy in grade IV splenic trauma: A case report associated with high-grade renal trauma |
| title_full |
Minimally invasive splenectomy in grade IV splenic trauma: A case report associated with high-grade renal trauma |
| title_fullStr |
Minimally invasive splenectomy in grade IV splenic trauma: A case report associated with high-grade renal trauma |
| title_full_unstemmed |
Minimally invasive splenectomy in grade IV splenic trauma: A case report associated with high-grade renal trauma |
| title_sort |
minimally invasive splenectomy in grade iv splenic trauma: a case report associated with high-grade renal trauma |
| publisher |
Elsevier Ltd |
| publishDate |
2021 |
| url |
http://pa.bibdigital.ucc.edu.ar/3476/1/A_Pantoja%20Pachajoa_Palacios%20Huantuco_Bruera.pdf |
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1832592352190922752 |