All: acute lymphoblastic leukaemia.
of a splenic injury depends on the severity of the injury, the experience of the surgeon, and the facilities available. Grade I injuries may be treated by observation with regular follow-up haemoglobin checks (e.g. 4 hourly) and intermittent scanning (e.g. every 2-3 days). Splenic conservation surgery by fibrin glue, patching or packing with haemostatic material, suturing, partial resection or wrapping in absorbable sheets such as polyglycolic acid, may be considered for grade II and III injuries. Splenectomy should be performed for all grade IV injuries, and also for grade II and III injuries if facilities for close follow-up is not available and/or if the surgeon is inexperienced with dealing with splenic trauma.
Implantation of diced pieces of splenic tissue into the omentum after splenectomy, with the hope that these islands of splenic tissue will restore normal splenic function, have been tried for many years. Unfortunately, although successful implantation has been achieved, the ectopic splenic tissue has not been shown to be functional.
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