A Case of Laparoscopic Splenectomy for Blunt Splenic Rupture after Abdominal Trauma

Sumito Takagi, Hironori Kaneko, Keiji Okada, Masaaki Yoshino, Jun Ishii, Tadaaki Shiba and Hijiri Watanabe^*

Second Department of Surgery, Toho University, School of Medicine
First Department of Surgery, Toho University, School of Medicine^*

We report a case of laparoscopic splenectomy for splenic rupture in a patient undergoing laparoscopy following abdominal trauma, who could not be treated conservatively. A 14-year-old child was transported to our hospital after abdominal trauma in a soccer game. CT scan and ultrasonography revealed a complex type of splenic rupture (Grade IIIc) and intra-abdominal bleeding. Although his vital signs were stable, emergency laparoscopy was conducted due to increase of the intra-abdominal bleeding and progressing anemia. Laparoscopic splenectomy was carried out with a Harmonic scalpel and an Endo-GIA since splenic fragmentation (Grade IIId) was found. The postoperative course was uneventful anf the patient was discharged 14 days after operation without any complications. In conclusion, we believe that laparoscopic management for blunt splenic rupture is one of the diagnostic and therapeutic strategies available, and that it plays an important role in determining whether splenectomy or conservative therapy should be selected.

Key words
laparoscopic splenectomy, blunt splenic rupture, diagnostic laparoscopiy

Reprint requests
Sumito Takagi Second Department of Surgery, Toho University, School of Medicine 6-11-1 Ohmori-nishi, Ohta-ku, Tokyo, 143-8541 JAPAN

Accepted
January 26, 2000

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