The management of splenic injuries in a District General Hospital

Between January 1987 and March 1992, 52 patients with splenic injuries were treated at Northampton General Hospital. Thirty-nine were men, 13 women with a mean age of 30 years (range 5-80 years). Splenic injuries were graded in severity from one to five using the organ injury scaling. Fifteen percent were Grade one injuries, 33% Grade two, 25% Grade three, 21% Grade four and only 6% Grade five. Forty (76%) of injured spleens required splenectomy, 6 (12%) had splenorrhaphy performed and 6 (12%) were conservatively treated. In 50% of Grade 1 injuries, 29% Grade 2 injuries and 23% of Grade 3 injuries the spleen was preserved either by nonoperative treatment or by splenorrhaphy. All of Grade 4 and 5 injuries required splenectomy. Methods for improving the rate of splenic conservation are discussed.