Conservative treatment of spleen rupture

The human spleen is mainly composed of lymphatic tissue, so the spleen has become the largest immune organ in the human body. The spleen also plays a very important role in the human body's metabolism, but if the spleen ruptures, you must go to the hospital for treatment. Severe spleen rupture requires surgical intervention for treatment, but what is the conservative treatment method when the spleen ruptures?

Conservative treatment of traumatic splenic rupture is commonly referred to as non-surgical treatment. The success rate of non-surgical treatment for traumatic splenic rupture is between 30% and 85%, and the success rate in children has been reported to be as high as 100%. Indications:

①Being under 50 years old;

② Non-open blunt trauma;

③Only spleen trauma, no other abdominal organ contusion;

④ Hemodynamics is stable, blood transfusion is no more than 2 to 4 units, examination indicators are stable, there is no coagulation disorder, and the hematoma is no longer expanding as observed by B-ultrasound;

⑤Clinical symptoms gradually improved.

Patients receiving non-surgical treatment should be placed in the intensive care unit (ICU), absolutely rest in bed, fast for at least 24 hours, and have continuous gastric tube and infusion to maintain water and electrolyte balance, blood transfusion (no more than 40ml/kg), maintain stable cardiovascular function, keep the pulse rate no more than 100 times/min, and maintain systolic blood pressure at 12kPa. Patients receiving non-surgical treatment should refrain from strenuous exercise or labor for at least 3 months to avoid further bleeding.

During the non-surgical treatment period, if any of the following conditions occur, surgery is necessary:

① Abdominal pain and tenderness worsen, and there may even be peritoneal irritation signs such as abdominal muscle rigidity;

② Patients with hemodynamic instability after receiving more than 4 units of blood transfusion within 48 hours or more than 40 ml per kilogram of body weight within 24 hours;

③ During dynamic observation, the hematocrit level drops by more than 6% after being stable for 24 hours, or the hematocrit level drops to 25% again, and the condition cannot be corrected quickly by transfusing 2 units of blood;

④ Other serious combined injuries in the abdomen were found during the observation period.