The sample size of our study was 98 patients. We found that the mean age of the patients was 19.03 years with a standard deviation of 17.46 years. The age of the patients ranged from 2 years to 85 years. The percentage of males was 71.4%, and the percentage of females was 28.6%. The percentage of those with blunt trauma was 99%, and those with penetrating trauma was 1%. Pain in the left hypochondrium was found in 86 patients (87.8%), and signs of hypovolemic shock were found in 12 patients (12.2%). Among the patients with hypovolemic shock, tachycardia, hypotension, and dry mucous membranes were found in all of them, while oliguria was found in only 3 patients (25%). In this sample of patients, echo was performed for all shocked patients (12.2%), CT scan was performed for 7.1% of stable patients, CT scan and echo were performed for 13.3% of stable patients, and no radiological examination was performed for the remaining stable patients (67.3%).
We found that 22 patients (22.4%) had a spleen grade determined, among them the most common was grade IV spleen damage (45.6%), followed by grade II and V spleen damage (18.2%) each, followed by grades I and III (9.1%) each, and 77.6% of patients did not have a specific grade of damage.
We found that the percentage of lesions accompanying spleen damage was 7.1%, and the percentage of isolated lesions was 92.9%.
We previously mentioned that the number of stable patients was 86 patients, representing 87.8%, 74 patients, representing 86%, were treated surgically (excisional surgery or conservative surgery), and 12 patients, representing 14%, were treated conservatively.
We previously mentioned that the number of patients who underwent surgical treatment was 74 patients, representing 86%, and among these patients, 91.9% of them underwent excisional surgery, and 8.1% of them underwent conservative surgery.
The average duration of monitoring for all patients was 4.56 days with a standard deviation of 3.45 days, and the values ranged between one day and 20 days.
91.7% of the shocked patients were treated with splenectomy, while 8.3% were treated conservatively.
Most patients, representing 86.7%, were monitored for vital signs every 24 hours, 8.2% of patients were monitored for vital signs every 12 hours, and 2% of them were monitored every two days.
74.5% of patients had an abdominal examination every 24 hours, while 9.2% of patients had an examination every 12 hours. We found that 16.3% did not have an abdominal examination during follow-up.
Only 9.2% of patients underwent ultrasound monitoring every 8 hours, 8.2% of patients underwent ultrasound monitoring every 6 hours, only 6.1% of patients underwent monitoring every 24 hours, 1% underwent monitoring every two days, 2% underwent monitoring every 12 hours, and the remaining patients (73.5%) were not monitored.
The percentage of CT monitoring upon admission only was 20.5%, the percentage of CT upon admission and discharge was 2%, and those who were not monitored by CT were 78.5%.
The number of patients who underwent blood transfusion while in the hospital was 69 patients (70.4%), and the average number of transfused units was 2.45 units with a standard deviation of 1.9 units, and the values ranged between 1 and 9 units.
The mortality rate in patients with splenic injury was 11.2%, the overall complications rate was 4.08%, the incidence of embolism was 50%, while the incidence of pneumonia and wound infection was 25% each.
Relationship between the degree of injury and the management of the stable patient
In this group of patients, all patients with grade I were managed conservatively, 75% of patients with grade II were managed conservatively, 100% of patients with grade III were managed conservatively, 100% of patients with grade IV were managed by excisional surgery, and 25% of patients with grade V were managed by excisional surgery with statistical significance (P = 0.000).
Relationship between the degree of injury and the management of the unstable patient
In this group of patients, we found that 75% of patients with grade V were treated with total splenectomy and 25% of patients with grade II were treated with partial excision with statistical significance (P = 0.000).