BACKGROUND: determining the common characteristics referring to the trauma mechanism and to the anatomic and physiological lesion of patients victim of splenic trauma. METHODS: The records of December/1999 to January/2003 were revised, being selected 524 of those by the Software TNVT Plus (version 2.0.0.213 - year 1996), admitted in the Emergency Service victims of thoracic-abdominal disease and subsequently interned. Of these records, were excluded those which did not present mechanism of contused trauma, the ones that deceased in the emergency room and the minors of 16 years of age. A sample with N=200 patients were studied. The variables of interest in the study were: etiology of the trauma, organ with the lesion, degree and segment of the lesion, systolic arterial pressure, cardiac frequency in the hospital admission and rib fracture. RESULTS: the splenic injury isolated had the greater incidence 39%, the hepatic-splenic associated lesion represented 14%. Of the 116 patients with diagnosis of splenic lesion, the classified anatomically in Degree IV was the most common (44 patients). The majority of the lesions had an auto-engine vehicle as the trauma mechanism - 56 patients, among which the lesion Degree III had greater prevalence 33,93%, standard comparable with the lesion Degree IV 32,14%. It was observed that 20% of the patients with lesion Degree III, IV or V had not described abdominal pain in their records, and in the lesions Degree I or II 30,13% did not describe pain. Medium Cardiac Frequency and Systolic Arterial Pressure were shown equivalent among different lesions. The greater incidence of splenic lesion was related to the absence of rib fracture. When diagnosed fracture, there was predominance of the group with isolated left ribs fractured, in which lesions Degree III, IV or V predominate with 62,50%. CONCLUSION: the accidents by automobile vehicle are the most common cause of splenic trauma and the mechanism of trauma which causes the most serious lesions, with the lesion Degree III being the most common among the victims of automobile vehicle accidents. 80% of the patients with lesion Degree III, IV or V described abdominal pain in their records revealing a significant parameter. Medium Cardiac Frequency and Systolic Arterial Pressure did not vary, neither when compared to the group with no lesion in solid organ. The probability of splenic lesion grows with fractures of isolated left ribs. In the present study, the group with lesions Degree III, IV or V predominates.
Abdominal injury; Splenic rupture; Spleen; Wounds; injuries
