Diagnosis and Treatment of Traumatic Splenic Injury

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 28; no. 6; pp. 819 - 823
• Main Authors: Hirakawa, Akihiko, Shimoto, Manabu, Tsuda, Masanobu, Iwase, Masaaki, Murao, Yoshinori, Nakatani, Toshio
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 30.09.2008
• Subjects: NOM
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.28.819

Splenectomy via emergency laparotomy has been a common procedure for traumatic splenic injury. However, with the recent improvements of imaging methods and advances in IVR, non-operative therapy is being performed more frequently. The guidelines for management at this Center are as follows : (1)Patients with stable hemodynamics or responders are followed, and TAE or surgery is considered when an increase of bleeding or new abdominal findings are observed. (2)For transient responders, TAE is performed when the injury is isolated, but TAE plus treatment of the associated disease is performed when the case is complicated by injuries in other regions. (3)For non-responders, laparotomy should be performed if intra-abdominal injury is their major diagnosis. However, patients with splenic injury frequently also have injuries in other regions, so the treatment priority for those in shock on arrival must be decided rapidly to allow proper diagnosis and treatment on the basis of the managing physician's judgment.