Spleen Injuries: Techniques

The spleen is one of the most commonly injured organs following blunt trauma. The injured spleen is a major source of morbidity and mortality and can be rapidly fatal if hemostasis is not promptly achieved. Up to one-third of patients with splenic injuries proceed directly to the operating room for surgical exploration. Patients who have had splenectomy are at risk for the usual morbidities of laparotomy but are also at increased risk for overwhelming sepsis syndromes due to asplenia. Nonoperative management also has risks including failure of nonoperative management, delayed hemorrhage, splenic infarction and abscess, and complications of angiography, if used. Given the common nature of the injury and the risks with all forms of management, the trauma surgeon must be well versed in the techniques required to care for this disease.