TRANSTHORACIC OPERATIVE APPROACH FOR TRAUMATIC LESIONS OF THE SPLEEN

Splenic injuries are not uncommon among battle casualties and are usually associated with other intra-abdominal or intrathoracic injuries. Today the consensus is entirely in favor of splenectomy for splenic injury, and splenic suture has been abandoned, so far as we have been able to determine. The preferable incision for splenectomy in these circumstances depends to some extent on concomitant injuries.

While statistics for this theater of operations are not available at present, observation of patients admitted from forward hospitals and conversation with other surgeons give the impression that the majority of splenectomies are performed through a vertical left rectus incision with or without a transverse extension. A few cases have been observed in which a transverse incision has been used. We and others have utilized a third operative approach, namely, the transthoracic route. In a survey of the literature which our facilities make available, we have been unable to find