c l i n i c a l f o l i o s : n a r r a t i v e





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Splenectomy for Grade IV Injury: 10

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Packing was removed from the left upper quadrant and clot was evacuated.     

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Splenectomy for Grade IV Injury: 11

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The spleen was elevated by bluntly mobilizing the already disrupted splenorenal ligament (see splenectomy). The spleen and tail of the pancreas were elevated into the wound. The disruption of the splenic capsule is visible.    

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Splenectomy for Grade IV Injury: 12

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The splenic hilar vessels were identified from the posterior side and individually clamped. There was no active bleeding because of the proximal control, so a vascular clamp was not necessary across the pedicle. Avoiding the use of the vascular clamp reduced the risk of injury to the tail of the pancreas.    

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This page was last modified on 11/7/2003.