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Optimal Management of Blunt Splenic Injury in the Geriatric Patient

  • James M. Haan
Chapter

Abstract

This chapter reviews the optimal management of geriatric patients with splenic injury. It emphasizes the importance of hemodynamic stability in attempting nonoperative management. It not only emphasizes systolic blood pressure of 90 mmHg as a marker of shock but also provides the evidence in defining shock 110 mmHg in the elderly as shock and additionally the concept of occult shock. As both age and increasing splenic injury grade of three or greater are predictors of nonoperative failure even those determined to be hemodynamically stable, the author advocates a more aggressive use of angioembolization in this cohort. The rationale for preference of proximal splenic artery embolization over distal or selective is described. A stepwise final algorithm is then listed balancing the potential risks and benefits in management choices.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Trauma Services, Trauma Services Via Christi Hospitals, Via Christi Hospitals St. Francis CampusWichitaUSA

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