A Review of Non-Operative Treatment of Splenic Trauma

From January 1984 to June 1992, a period of 8.5 years, 60 patients with splenic trauma were treated in Lacor Hospital. The spleen trauma was managed conservatively in 47 (78%) of the patients. Of these, 36 of the patients (60%) were not operated upon. Eleven (18%) were operated upon but nine (15%) patients had exploratory laparotomy only without spleen manipulation and in two (3%) splenic repair was performed. Thirteen (22%) patients had splenectomy. In the non-operative group, recurrent or rebleeding was detected in one patient (2%) and delayed bleeding occurred in five patients (8%). Overall mortality rate was five (8%); two (3%) occurring in splenic salvage and three (5%) in splenectomized patients. It is concluded that with availability of facilities and personnel, in selected cases of blunt splenic trauma, splenic conservation is safe but requires close monitoring.