| Preserved splenic function after angioembolisation of high grade injury. | |
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MedLine Citation:
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PMID: 20673894 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: After introducing splenic artery embolisation (SAE) in the institutional treatment protocol for splenic injury, we wanted to evaluate the effects of SAE on splenic function and assess the need for immunisation in SAE treated patients. METHODS: 15 SAE patients and 14 splenectomised (SPL) patients were included and 29 healthy blood donors volunteered as controls. Clinical examination, medical history, general blood counts, immunoglobulin quantifications and flowcytometric analysis of lymphocyte phenotypes were performed. Peripheral blood smears from all patients and controls were examined for Howell-Jolly (H-J) bodies. Abdominal doppler, gray scale and contrast enhanced ultrasound (CEUS) were performed on all the SAE patients. RESULTS: Leukocyte and platelet counts were elevated in both SAE and SPL individuals compared to controls. The proportion of memory B-lymphocytes did not differ significantly from controls in either group. In the SAE group total IgA, IgM and IgG levels as well as pneumococcal serotype specific IgG and IgM antibody levels did not differ from the control group. In the SPL group total IgA and IgG Pneumovax(®) (PPV23) antibody levels were significantly increased, and 5 of 12 pneumococcal serotype specific IgGs and IgMs were significantly elevated. H-J bodies were only detected in the SPL group. CEUS confirmed normal sized and well perfused spleens in all SAE patients. CONCLUSION: In our study non-operative management (NOM) of high grade splenic injuries including SAE, was followed by an increase in total leukocyte and platelet counts. Normal levels of immunoglobulins and memory B cells, absence of H-J bodies and preserved splenic size and intraparenchymal blood flow suggest that SAE has only minor impact on splenic function and that immunisation probably is unnecessary. |
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Authors:
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Jorunn Skattum; Thomas Larsen Titze; Johann Baptist Dormagen; Ingeborg S Aaberge; Anne Grete Bechensteen; Per Ivar Gaarder; Christine Gaarder; Hans Erik Heier; Pål Aksel Næss |
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Publication Detail:
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Type: Journal Article Date: 2010-07-31 |
Journal Detail:
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Title: Injury Volume: 43 ISSN: 1879-0267 ISO Abbreviation: Injury Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-01-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0226040 Medline TA: Injury Country: Netherlands |
Other Details:
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Languages: eng Pagination: 62-6 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Trauma Unit, Oslo University Hospital Ullevaal, Kirkeveien 166, N-0407 Oslo, Norway. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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