[Conservative treatment of splenic injuries in adults. Conservation or surgery?]

A preservative attitude towards splenic traumatism is globally no more discussed. But the best way to succeed for the general surgeon has to be precise: non operative either coeliotomy for preservative surgery? About 55 observations of splenic traumatisms, the authors compare advantages with drawback of each position and try to show out the factors acting on each choice to aim a preservative score the highest possible. Now the global preservative score is 47%. The non operative proceeding lead 5/12 to failure. 10 preservative surgery initially performed lead to 10 success: preservative surgery, in our hands give the best results. Preservative surgery for a greater number of cases, and mainly for polytraumatisms (or multiple contusions) for which the collaboration of surgeons from different specialties make more difficult, for more stratified, the supervision in case of non operative proceeding.