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. 2020 Feb 25:26:e922862.
doi: 10.12659/MSM.922862.

Intermittent Splenic Artery Occlusion Plus Gauze Compression Is a Simple and Effective Treatment for Iatrogenic Splenic Injury

Libin Yao  1 , Ponnie Robertlee Dolo  1 , Zhichao Li  1 , Jason Widjaja  1 , Xiaocheng Zhu  1
Affiliations

Intermittent Splenic Artery Occlusion Plus Gauze Compression Is a Simple and Effective Treatment for Iatrogenic Splenic Injury

Libin Yao et al. Med Sci Monit. .

Abstract

BACKGROUND The aim of this study was to evaluate the feasibility and safety of intermittent splenic artery occlusion plus gauze compression in treating iatrogenic splenic injury. MATERIAL AND METHODS We retrospectively analyzed 12 iatrogenic splenic injury cases (grade I to III) treated with intermittent splenic artery occlusion plus gauze compression. The hemostatic effect was then observed after unblocking and decompression. The total operation time, gauze compression time, total blood loss, blood loss from the injured spleen, and platelet counts of each patient before and 1 week after surgery were noted. RESULTS The average operation time was 209.58±57.11 min, and the average gauze compression time after spleen artery occlusion was 23.75±4.33 min. The average total blood loss and blood loss due to iatrogenic spleen injury were 468.33±138.22 ml and 264.17±165.72 ml, respectively. Two cases (both grade I) had successful hemostasis after 15 min of splenic artery occlusion and wound compression. Another 9 cases (all grade II) and 1 case (grade III) attained hemostasis after 25 min and 30 min, respectively, of splenic artery occlusion and wound compression. The platelet counts of all patients were within the normal range before and 1 week after surgery. No postoperative complications occurred. CONCLUSIONS Intermittent splenic artery occlusion plus gauze compression is a simple and effective treatment for iatrogenic splenic injury.

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Conflict of interest statement

Conflict if interests

None.

Figures

Figure 1
Figure 1
Illustrations of surgical procedure of intermittent splenic artery occlusion combined with gauze compression in iatrogenic splenic injury during radical gastrectomy. (A) Splenic laceration occurred in the inferior pole during surgery. (B) The splenic artery was separated. (C) The splenic artery was intermittently occluded using non-traumatic Bulldog arterial clamping, and the injured part of the spleen was compressed using gauze. (D) Active bleeding of the injured part stopped after releasing compression.
Figure 2
Figure 2
Platelet counts before and 1 week after surgery in all patients. The platelet counts in all patients were within the normal range before and 1 week after surgery, and was 273.83±56.22×109/L before surgery and 227.83±48.59×109/L 1 week after surgery.
See this image and copyright information in PMC

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