Nonoperative Management of the Damaged Spleen: A Community Surgeon Looks Back

摘要

Blunt spleen injury is usually managed nonoperatively. An 8-year retrospective analysis by one community surgeon was done to provide an overview of the role of CT, angiography, and transfusion in the management algorithm. A total of 2750 patients were screened and 125 patients were identified with spleen injury. Of these 125 patients, 72 were managed without surgery. These were young (mean age 32 6 16 years) patients with mean Injury Severity Score of 16 6 8. Angiography was used in 14 patients. These patients received more blood (5 6 6 vs 2 6 units of packed red blood cells) than their nonangiogram counterparts. Overall failure of nonoperative care was 3 per cent. Community surgeons can provide safe nonoperative care and current adjuncts including angiography may enhance splenic salvage.