Spleen Surgery Flashcards
What are 3 reasons for splenic surgery?
- Trauma
- Isolated splenic lesions
- Hypersplenism
True or false:
Most splenic injuries can be observed initially (except grade V)
True
What are 2 indications for a laparotomy?
- Other intra-abdominal injuries.
2. Failure of non-operative management
Name 4 other indications for a laparotomy :
- 2nd line treatment in immune thrombocytopenia
- Splenomegaly in myelofibrosis
- Hereditary spherocytosis
- Left sided portal hypertension
Name 4 pre-operative management preparations:
- Type and cross match of blood
- Prophylactic antibiotics
- Immunization
- Counseling
Name the 2 types of immunization therapies, used as pre-operative management preparations:
- Mention which is most effective in children.
- PPSV23 (PNEUMOVAX)
- PCV13 (PREVNAR)
- Most effective in Children
Note: Both types should be used in adults.
Revaccination should happen 5years after initial dose.
What techniques are used for splenic surgery.
- Open surgery
- Laparotomy
- Partial splenectomy
- Salvage techniques
What are the salvage techniques used in splenic surgery?
Splenorrhaphy
Partial splenectomy
Haemostatic patches
(Splenic embolisation. )
What is splenorhaphy?
Suture repair of the spleen with or without wrapping
What are 3 splenorhappy conventional suture techniques?
Haemostatic agents
Coagulation
What are some advantages of slenorraphy?
Tamponade effect
No increase infective risk
What are some disadvantages of slenorraphy?
Time consuming
Ischaemia
Recurrent bleeding
What is partial splenectomy?
Removal of a part of the spleen according to vascular supply
What are some disadvantages of a partial splenectomy ?
Large raw surface with high risk for bleeding.
What are some postoperative complications of splenic surgery?
- Post op bleeding.
- Peri-operative bleeding.
- Postsplenectomy sepsis.
- Vascular thrombosis.
- Gastric perforation.
- Pancreatic fistula
