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Blunt splenic trauma: Assessment, management and outcomes
Moamena El-Matbouly1, Gaby Jabbour1, Ayman El-Menyar2
1Department of Surgery, Hamad General Hospital, Doha, Qatar.
Summary
Non-operative management (NOM) is increasingly favored for blunt splenic injury (BSI). Careful patient selection for NOM ensures high success rates, reduced complications, and lower mortality in blunt abdominal trauma cases.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Radiology
Background:
- Blunt splenic injury (BSI) management has shifted towards non-operative management (NOM).
- Current practices for BSI evaluation, diagnosis, and treatment require review.
- NOM is becoming the standard for hemodynamically stable patients.
Purpose of the Study:
- To review current practices in the diagnosis and management of blunt splenic injury (BSI).
- To evaluate the effectiveness and outcomes of non-operative management (NOM) versus operative management (OM).
Main Methods:
- A traditional narrative literature review was conducted.
- Searches were performed on PubMed, MEDLINE, and Google Scholar.
- Keywords included "Traumatic Splenic injury", "Blunt splenic trauma", and "management" from 1954 to 2014.
Main Results:
- NOM is supported for hemodynamically stable patients, guided by improved diagnostic modalities.
- NOM for high-grade injuries has higher failure rates, prolonged hospital stays, and risks of delayed hemorrhage.
- Treatment decisions should integrate clinical presentation, surgeon experience, and radiographic findings.
Conclusions:
- Blunt splenic injury (BSI) accounts for approximately 25% of blunt abdominal trauma.
- Clinical suspicion and accurate radiological diagnosis are crucial for timely management decisions (OM vs. NOM).
- Careful selection of NOM leads to high success rates with reduced morbidity and mortality.
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