Management of Traumatic Splenic Injuries

Any acute trauma in a patient warrants a thorough history and physical examination following initial assessment and stabilization as required. In particular, history of blunt abdominal trauma should prompt concerns for splenic injury, with motor vehicle collisions (MVC) often identified as the most common cause of injury. Splenic injury can be managed both operatively and non-operatively based on injury severity and patients’ physiologic response to trauma. Vitals, physical examination findings, and imaging can help guide management. Exploratory laparotomy is typically necessary in hemodynamically unstable patients and/or in patients suspected of having severe splenic injury. Non-operative management can include angioembolization and requires careful monitoring of patients for changes in vital signs. Regardless of management strategy, counseling on sports/activity restrictions and patient follow-up are vital.