Traumatic splenic injury: splenectomy vs. repair

Splenectomy has been the standard treatment during this century for traumatic splenic injuries. Because of the association between asplenia and overwhelming sepsis, recent attempts have been made to repair injured spleens. Details of splenic anatomy and blood supply allow prediction of the usual type of splenic injury that can be repaired. By utilizing a topical hemostatic agent, capsular sutures, and arterial ligation, severely traumatized spleens have been repaired. Postoperative splenic scanning is available in assessing remaining splenic tissue. The present and future ramifications of reparative splenic surgery are presented.