Standard of care for blunt spleen trauma: embracing non-operative management

Résumé fourni par la source

Non-operative management is the standard of care for blunt spleen trauma in stable patients in the absence of other abdominal injuries. This is a case report of a male patient in his 60s who presented to the emergency room with abdominal pain 2 days after sustaining blunt abdominal trauma. The patient was haemodynamically stable, and CT scan revealed a severe spleen injury. Considering the clinical stability, the patient was admitted for non-operative management and kept under continuous monitoring. A CT angiogram revealed active bleeding, so the patient underwent angioembolisation of the distal splenic artery. Follow-up after angioembolisation was uneventful, and imaging findings were stable, so the patient was discharged after 12 days. Non-operative management is a valid option for stable patients, avoiding surgical complications while preserving spleen function. Being a dynamic process, it should be an option in centres with continuous monitoring capacity and emergency surgery availability, considering the potential failure of this approach.