THE INJURED SPLEEN: SHOULD CONSIDERATION BE GIVEN TO CONSERVATIVE MANAGEMENT?

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Abstract
This report is a retrospective study over a 13 yr period of 267 patients who underwent splenectomy. The incidence of associated major abdominal injuries following blunt trauma in these patients was 8%. Over 1/2 of these associated injuries were diagnosed preoperatively. Of the patients 69% were hemodynamically stable before operation. Patients who suffered splenic injuries while playing sport or who were conscious and did not have major extra-abdominal injuries or clear evidence of other intra-abdominal injury could possibly have been managed expectantly. Such a policy might have avoided splenectomy in a substantial number of cases and thus have eliminated the risk of overwhelming post-splenectomy infection (OPSI) in these patients.