Blunt Trauma to the Spleen

Abstract

Management of blunt splenic injury remains controversial. The decision to pursue non-operative management rather than splenic conservation or splenectomy depends on the individual merits of each case. There is an increasing trend towards splenic conservation, particularly in younger, stable patients with single organ injury.

Management of Splenic Injuries in a University Teaching Hospital in Nigeria

“…15 Increased length of stay in the OM group has been similarly documented. 5,13 Intensive care unit (ICU) admission was influenced by injury grade, amount of haemoperitoneum, transfusion requirements, presence of coagulopathy, associated injuries or presence of comorbidity.…”

Recent Changes in the Management of Blunt Splenic Injury: Effect on Splenic Trauma Patients and Hospital Implications

“…1 However, this changed policy towards splenic conservation requires careful risk-benefit analysis in the face of potentially life-threatening haemorrhage from delayed splenic rupture and the possibility of transfusion-induced viral infections. Furthermore, the increasing availability of reliable and good quality radiological imaging including ultrasound, computerised tomography (CT) scanning, and magnetic resonance imaging (MRI) have greatly improved the information available with regard to the nature of the splenic injury and this may well help to identify the suitable patients for conservative management, 2 but at the expense of patient radiation.…”

Splenic trauma - our experience at a level I Trauma Center

“…Other problems in NOM highlighted in the literature include the greater requirement of blood transfusions and transfusion-related complications. [2] In our series, requirement of blood transfusions in the operative group was significantly higher than in the non-operative group. Another consideration for NOM is the possibility of missing other associated intra-abdominal injuries.…”

“…[1] However, this policy change towards splenic conservation requires careful risk-benefit analysis in the face of potentially life-threatening hemorrhage from delayed splenic rupture and the possibility of transfusion-induced viral infections. Furthermore, the increasing availability of reliable and good quality radiological imaging, including ultrasound and computerized tomography (CT) scanning, has greatly improved the information available with regard to the nature of the splenic injury, and this may well help to identify the suitable patients for NOM, [2] but at the expense of radiation to the patient.…”