Management of Traumatic Splenic Injuries
Any acute trauma in a patient warrants a thorough history and physical examination following initial assessment and stabilization as required. In particular, history of blunt abdominal trauma should prompt concerns for splenic injury, with motor vehicle collisions (MVC) often identified as the most common cause of injury. Splenic injury can be managed both operatively and non-operatively based on injury severity and patients’ physiologic response to trauma. Vitals, physical examination findings, and imaging can help guide management. Exploratory laparotomy is typically necessary in hemodynamically unstable patients and/or in patients suspected of having severe splenic injury. Non-operative management can include angioembolization and requires careful monitoring of patients for changes in vital signs. Regardless of management strategy, counseling on sports/activity restrictions and patient follow-up are vital.
KeywordsAbdominal trauma Embolization Grade Laparotomy Spleen Splenic injury
- 1.Diercks DB, Clarke S. Initial evaluation and management of blunt abdominal trauma in adults. In: UpToDate, Post TW, editors. UpToDate, Waltham, Accessed via https://www.uptodate.com/contents/initial-evaluation-and-management-of-blunt-abdominal-trauma-in-adults on 7 July, 2017.
- 2.Maung AA, Kaplan LJ. Management of splenic injury in the adult trauma patient. In: UpToDate, Post TW, editors. UpToDate, Waltham. Accessed via https://www.uptodate.com/contents/management-of-splenic-injury-in-the-adult-trauma-patient on 7 July, 2017.
- 5.Stassen NA, Bhullar I, Cheng JD, Crandall ML, Friese RS, Guillamondegui OD, Jawa RS, Maung AA, Rohs TJ, Sangosanya A, et al. Selective nonoperative management of blunt splenic injury: an Eastern Association for the Surgery of trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5.4):S294–300.CrossRefGoogle Scholar
- 6.Maung AA, Kaplan LJ. Surgical management of splenic injury in the adult trauma patient In: UpToDate, Post TW, editors. UpToDate, Waltham. Accessed via https://www.uptodate.com/contents/surgical-management-of-splenic-injury-in-the-adult-trauma-patient on 7 July, 2017.