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Changing concepts in the management of splenic trauma.

Overwhelming sepsis may occur, even years later, in asplenic children or adults who are otherwise healthy. The injured spleen can be successfully repaired in almost all patients. Repair should not be attempted if the survival of the patient would be jeopardized by continuing or delayed hemorrhage. If splenectomy is unavoidable, the patient must be informed of his vulnerable state and be protected as much as possible by vaccines and by early aggressive treatment of all infections.