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Different treatment modalities in traumatic splenic injuries

Objective To evaluate surgical and nonoperative splenic conservation modalities in traumatic splenic injuries. Background Splenic injury is common, affecting up to 32% of patients with blunt abdominal trauma. Nonoperative management (NOM) of hemodynamically stable patients with blunt splenic injury has become the standard of care in pediatric and adult populations. Successful outcome following NOM is reported as up to 97% of patients regardless of the grade of splenic injury. Patients and methods This was a prospective study including 150 patients) 88 patients and the other one contained 62 patients (at Menoufia University Hospital, General Surgery Department, and Itay El Baroud General Hospital, General Surgery Department, during December 2018 to October 2019. Patients were divided into two groups: group I included patients who were hemodynamically stable, without signs of peritonitis, and group II included patients who were hemodynamically unstable and were managed operatively according to grade of injury by splenectomy, partial splenectomy, and selenography of a tear. Full history taking, clinical examination, complete blood count, and ultrasound sonographic examination were done. Results In the current study, the first group consists of 88 patients and only 22 needed blood transfusion, but in the second group, all patients needed blood transfusion. Moreover, in the first group, the minimum hospital stay was 5 days, the maximum was 9 days, and the mean were 6.40 ± 1.35, whereas in the second group, the minimum of hospital stay was 5 days, and the maximum was 7 days, with mean of 6.0 ± 0.79. Conclusion NOM for blunt splenic trauma in hemodynamically stable patients is safe, effective, and associated with low morbidity and no mortality. However, NOM should be practiced in hospitals where an efficient ICU is available.