[Organ-preserving therapy of splenic rupture in adults?]

For decades the spleen was not contemplated a vital organ and was removed at the smallest laceration. Recently, it has become clear that patients who have undergone splenectomy at any age have an increased risk of overwhelming bacterial infections and septicemia. Removing the spleen is now thought to be catastrophic by many. An injured spleen should be preserved at any cost, with glue, suture or by partial resection. Which is true? Organ preserving therapy should be considered in each case. This is rather difficult to do. The experience and ability of the respective surgeon are important factors in this management. However, the patient should never be endangered by exsanguinating hemorrhage while it is tried to preserve the organ.