[Diagnostics and stage-conform treatment of splenic injuries]

Splenic injuries often represent severe internal injuries in cases of abdominal trauma. Contrast-enhanced computed tomography (CT) and laboratory diagnostics play a particularly important role in the diagnostics. Traumatic splenic injuries are classified according to the American Association for the Surgery of Trauma (AAST) and World Society of Emergency Surgery (WSES) criteria. The degree of injury and the hemodynamic and clinical situation of the patient are decisive factors in the choice of treatment. Nonoperative management (NOM) is used in cases of hemodynamic stability and minor splenic injuries. Close clinical monitoring, laboratory and sonographic control examinations are essential in this context. Bleeding and pseudoaneurysms can be successfully treated using angioembolization, a procedure of interventional radiology. Splenorrhaphy can be used as a surgical measure. Total splenectomy is the last life-saving measure for splenic injuries. After splenectomy vaccination prophylaxis and patient education to prevent severe infections are an integral part of the procedure.