Conservative Management of Splenic Injuries

Abstract

he spleen is one of the most frequently injured organs in abdominal trauma. Non-operative management has gradually become the standard as long as the patient remains hemodynamically stable. The most common cause of splenic injuries is blunt abdominal trauma. Also splenic injuries caused by penetrating injuries, for example, stab or gunshot wounds. Iatrogenic splenic injury is a recognized complication in abdominal surgery. The clinical signs and symptoms vary widely. Abdominal ultrasonography especially (FAST) is efficient and can detect intraperitoneal fluid. Patients who are unstable with positive abdominal findings and positive (FAST) require a laparotomy. When (FAST) is negative and the patient is haemodynamically unstable we must search for another source of the haemodynamic instability of the patient. In the haemodynamically normalized patient, when (FAST) is positive and CT is available, we recommend doing CT for detecting the degree of splenic injury and for accurate selection of the proper method of treatment. Controversy exists about how to appropriately select patients for non-operative treatment since bleeding from splenic injuries can incur significant morbidity and mortalit