The spleen is one of the more commonly injured intra abdominal organs. In most cases the spleen can be conserved. The management is dictated by the associated injuries, haemodynamic status and extent of direct splenic injury.

Investigations

• CT - Diagnosis and grading

Management

Conservative (Grade 1-3 injuries) -

• Small subcapsular haematoma
• Minimal intra-abdominal blood
• No hilar disruption

Laparotomy with conservation -

• Increased amounts of intraabdominal blood
• Moderate haemodynamic compromise
• Tears or lacerations affecting <50%

Resection (Grade 4/5) -

• Uncontrollable splenic bleeding
• Hilar vascular injuries
• Devascularised spleen