000			01559cam a2200205 4500
001			NMDX7067
008			120401t2012 xxu||||| |||| 00| 0 eng d
100			_aMatar, H.E.
240			_aBMJ Case Reports
245			_aTraumatic splenectomy in a cirrhotic patient with hepatitis C and alcoholic liver disease
260			_c2012
500			_aNMUH Staff Publications
520			_a<span style="font-size: 10pt;">Non-operative management is the management of choice for haemodynamically stable patients with blunt splenic injury. However, coexistent liver cirrhosis poses significant challenges as it leads to portal hypertension and coagulopathy. A 52-year-old man sustained blunt abdominal trauma causing low-grade splenic injury. However, he was found to have liver cirrhosis causing haemodynamic instability requiring emergency laparotomy. His portal hypertension led to severe bleeding only controlled by aortic pressure and subsequent splenectomy. Mortality from emergency surgery in cirrhotic patients is extremely high. Despite aggressive resuscitation, they may soon become haemodynamically unstable. Therefore, traumatic splenectomy may be inevitable in such patients with portal hypertension and splenomegaly secondary to liver cirrhosis even in low-grade injury.</span>
700			_aElmetwally, A.S.
700			_aNair, MS.
700			_aBorgstein, R.
700			_aOluwajobi, O.
856			_uhttps://www.ncbi.nlm.nih.gov/pubmed/22665581
856			_uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542979/pdf/bcr.07.2011.4478.pdf
999			_c76070 _d76070