Splenic Trauma

Author(s): Takeshi Shimazu

Pp: 264-275 (12)

DOI: 10.2174/978160805273811101010264

* (Excluding Mailing and Handling)

Abstract

The spleen is one of the most frequently injured solid organs in blunt abdominal trauma [1]. In the history of trauma care, however, injuries of the spleen have received but scant attention compared to those of the liver and the kidney. Splenectomy has long been the preferred and standard treatment for bleeding from the spleen caused by blunt trauma, because the spleen was regarded as to have no vital function [2]. Owing to the pioneering article of King and Schumacher on the correlation between asplenia and overwhelming infection, the role of the spleen as an immunologic organ particularly in children, came to be widely recognized in the 1960s [3-6]. Then, splenic preservation treatment such as splenorrhaphy, partial splenectomy, and splenic embolisation, became the optimal management techniques for blunt splenic injury [7,8]. Due to the advances in CT imaging and angiography, nonoperative management (NOM) became the optimal management techniques for blunt splenic injury, and splenic embolisation is a valuable adjunct to the NOM [9,10].

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      • 17. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      • 11. app/Models/ContentAccess.php:647
      • 12. app/Http/Controllers/ChapterController.php:1465
      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 14. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      • 11. app/Models/ContentAccess.php:647
      • 12. app/Http/Controllers/ChapterController.php:1478
      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 14. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51359025 and j.to_ip >=51359025 )) and ((j.from_date <= 1740775939 and j.to_date >= 1740775939 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 2402) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51359025 and j.to_ip >=51359025 )) and ((j.from_date <= 1740775939 and j.to_date >= 1740775939 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 2402) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51359025 and j.to_ip >=51359025 )) and ((j.from_date <= 1740775939 and j.to_date >= 1740775939 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 2402)
      820μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 956 and `b`.`banner_from_date` <= 1740775939 and `b`.`banner_to_date` >= 1740775939 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.46msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 956
      • 3: 1740775939
      • 4: 1740775939
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='75aedee03207cb8ae57ac2d7803c26eb'
      280μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:291
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Keywords
    1Keywords.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        UUAiR9jVcnkH1Rjs8P9PEZcwSnesBjol6sH6g6yk
        uc_cart_id
        75aedee03207cb8ae57ac2d7803c26eb
        _previous
        array:1 [ "url" => "http://alpha.eurekaselect.com/chapter/2402" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/2402
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:8 [ "accept-encoding" => array:1 [ 0 => "gzip, deflate" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] "connection" => array:1 [ 0 => "keep-alive" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] ]
        request_cookies
        []
        
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Fri, 28 Feb 2025 20:52:19 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkEvQkVvcWFHMUtFdkZSaFBKeVBMVEE9PSIsInZhbHVlIjoibmFyRzlLQlp0UDdLOVVEN21QVGRMVmZ0QVJtc0JMeE9ycDNrd1d5MTAzZ09PM1pWRkh0SmFNdFZ6QllFcjlqcHUrSy8zL2M4ZjdDUkVFdklYdnF1MlUwS0NxQ2VsRk9yS2x4UWQ2WS8xQXl5ZmJPNUFXbVFJVGxrdWZQVXdRbUwiLCJtYWMiOiI5ZjhlNGI0OThlZmE0NTViYjI5YjlkNTRkNzFkOTZjOWFmZTM0YTA1ZmI4ZmM2NzllMTdiZjU5ODM0MGY3NzZlIiwidGFnIjoiIn0%3D; expires=Mon, 03 Mar 2025 08:52:19 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IkEvQkVvcWFHMUtFdkZSaFBKeVBMVEE9PSIsInZhbHVlIjoibmFyRzlLQlp0UDdLOVVEN21QVGRMVmZ0QVJtc0JMeE9ycDNrd1d5MTAzZ09PM1pWRkh0SmFNdFZ6QllFcjlqcHUrSy8zL" 1 => "alphaeurekaselectnet_session=eyJpdiI6InMrclIxU2xUVW9jNGhmUkh1c1lkNHc9PSIsInZhbHVlIjoiOE00Qit4YlpkZzhHNlBKUFBZc2tZQ05FT2o2QytFbkdHRW0xRXAxUE01R08xRVczQTBTWVBsUlV5dXVjVERhaFFtK3hQRVpLRmNXeTBnbW1ZRE1XVnFvTlNiVFozbisxV0N4RUMzMzFzUmkrMHRqYzJQVS9mT1ZBcHpKVUUzVTUiLCJtYWMiOiIzODA2OTg1ZWVjM2QwMjNmY2ZhNzA5NGFhZWFhYWUyYTExYjJlZGZiNmNiNTI1NDY3ZDJhN2U4NWMwMDFjMmEwIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6InMrclIxU2xUVW9jNGhmUkh1c1lkNHc9PSIsInZhbHVlIjoiOE00Qit4YlpkZzhHNlBKUFBZc2tZQ05FT2o2QytFbkdHRW0xRXAxUE01R08xRVczQTBTWVBsUlV" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkEvQkVvcWFHMUtFdkZSaFBKeVBMVEE9PSIsInZhbHVlIjoibmFyRzlLQlp0UDdLOVVEN21QVGRMVmZ0QVJtc0JMeE9ycDNrd1d5MTAzZ09PM1pWRkh0SmFNdFZ6QllFcjlqcHUrSy8zL2M4ZjdDUkVFdklYdnF1MlUwS0NxQ2VsRk9yS2x4UWQ2WS8xQXl5ZmJPNUFXbVFJVGxrdWZQVXdRbUwiLCJtYWMiOiI5ZjhlNGI0OThlZmE0NTViYjI5YjlkNTRkNzFkOTZjOWFmZTM0YTA1ZmI4ZmM2NzllMTdiZjU5ODM0MGY3NzZlIiwidGFnIjoiIn0%3D; expires=Mon, 03-Mar-2025 08:52:19 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IkEvQkVvcWFHMUtFdkZSaFBKeVBMVEE9PSIsInZhbHVlIjoibmFyRzlLQlp0UDdLOVVEN21QVGRMVmZ0QVJtc0JMeE9ycDNrd1d5MTAzZ09PM1pWRkh0SmFNdFZ6QllFcjlqcHUrSy8zL" 1 => "alphaeurekaselectnet_session=eyJpdiI6InMrclIxU2xUVW9jNGhmUkh1c1lkNHc9PSIsInZhbHVlIjoiOE00Qit4YlpkZzhHNlBKUFBZc2tZQ05FT2o2QytFbkdHRW0xRXAxUE01R08xRVczQTBTWVBsUlV5dXVjVERhaFFtK3hQRVpLRmNXeTBnbW1ZRE1XVnFvTlNiVFozbisxV0N4RUMzMzFzUmkrMHRqYzJQVS9mT1ZBcHpKVUUzVTUiLCJtYWMiOiIzODA2OTg1ZWVjM2QwMjNmY2ZhNzA5NGFhZWFhYWUyYTExYjJlZGZiNmNiNTI1NDY3ZDJhN2U4NWMwMDFjMmEwIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6InMrclIxU2xUVW9jNGhmUkh1c1lkNHc9PSIsInZhbHVlIjoiOE00Qit4YlpkZzhHNlBKUFBZc2tZQ05FT2o2QytFbkdHRW0xRXAxUE01R08xRVczQTBTWVBsUlV" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "UUAiR9jVcnkH1Rjs8P9PEZcwSnesBjol6sH6g6yk" "uc_cart_id" => "75aedee03207cb8ae57ac2d7803c26eb" "_previous" => array:1 [ "url" => "http://alpha.eurekaselect.com/chapter/2402" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-28 20:52:19GET/chapter/2402112193