[Surgical treatment of injuries and diseases of the spleen].

The paper deals with experiences and procedures in the management of spleen injuries and diseases in 53 patients treated in the Department of Surgery of the Sibenik Medical Centre over the last 15 years. There were 40 patients with spleen injuries, sustained mainly in road traffic accidents (26 or 65%), various accidents in the workplace, at home, knife stabs etc. (14 or 35%). The majority of those injured in road traffic accidents were polytraumatized (77%). Splenectomy was done in 36 patients. Successful splenic salvage was accomplished in 2 cases by the patch procedure. Two children with spleen injuries were treated conservatively, with careful follow-up of laboratory findings, clinical course, scintigraphy and ultrasound findings. Among other diseases splenectomy was done in hypersplenism (3), in spontaneous rupture because of splenomegaly, metastatic carcinoma and hydatid cyst (1 patient respectively). Together with other surgical procedures splenectomy was done in total gastrectomy because of carcinoma (3), in left hemicolectomy also because of carcinoma (2), in haemorrhagic oesophageal varices surgery (1) and in lesion caused by an instrument (1). Because of questionable results, no autologous transplantation was done. There were no cases of postsplenectomy infection.