Journal of Angiotherapy
Integrative Biomedical Research (Journal of Angiotherapy) | Online ISSN  3068-6326
  1. You are here:
  2. Home
  3. Journals
  4. Biological Sciences
Journal of Angiotherapy

Volume 8 Number 1 2024

Article Contents

REVIEWS   (Open Access)
Contents Vol 8 (8)

Splenic Injury: A Comprehensive Review For Emergency Professionals

Ahmed Ali Shareefi 1, ?Fawaz Muslih Roud Alanazi 1, Mubarak Alhumaidi M Alshammari 1, ?Abdullaziz Aahad Abdullah Alwanais 1, ?Omar Mohammed Musaheb Al-Omari 1, Nader Abdulhadi Abdullah Aljohani 1, Mohammed Salem S Alqahtani 1, Naief Galet f Almutairi 1, ?Omar Mohammed Musaheb Al-Omari 1, ?Fawaz Muslih Roud Alanazi 1, Hezam Motlaq H. Alsahly 1, ?Turki Ahmed K. Almatrafi 1, ?Abdulaziz Saeed Alghamdi 1, ?Abdullah Saleh Khalaf Aldosari 1, ?Danah Ahmed Alshehri 1, Sara Saad Algarnispleni 1

+ Author Affiliations

Journal of Angiotherapy 8 (8) 1-8 https://doi.org/10.25163/angiotherapy.8810350

Submitted: 28 May 2024 Revised: 13 August 2024  Published: 15 August 2024 

Abstract

Background: Splenic injury is one of the most frequent complications of blunt abdominal trauma. It can lead to rapid internal bleeding and death if not managed promptly. Motor vehicle accidents, falls, and sports injuries are the most common causes. The spleen plays essential roles in immune surveillance and hematologic function, making organ preservation a priority whenever possible. Aim: This review aims to summarize current knowledge of splenic injury, with a focus on diagnosis, treatment options, and outcomes. It highlights the role of nonoperative strategies and imaging in improving survival while preserving splenic function. Methods: A review of recent clinical studies, trauma guidelines, and surgical literature was conducted. The data focused on patient presentation, hemodynamic status, imaging modalities, grading of splenic injury, and treatment protocols in both adult and pediatric populations. Results: Nonoperative management is the preferred approach in hemodynamically stable patients, with success rates exceeding 85%. CT imaging allows accurate grading and identification of active bleeding or vascular injury. Splenectomy remains essential for unstable patients. Pediatric patients show higher rates of successful nonoperative management. Embolization has emerged as a key adjunct in select cases. Mortality is closely tied to injury grade and time to intervention. Conclusion: Timely diagnosis, injury grading, and tailored treatment are central to reducing mortality and preserving splenic function. Multidisciplinary teamwork improves decision-making and outcomes, particularly in pediatric trauma. Further research should refine risk stratification and long-term outcomes.

Keywords: Splenic injury, blunt trauma, nonoperative management, splenectomy, CT imaging, embolization, pediatric trauma.

References

Boyle, T. A., Rao, K. A., Horkan, D. B., Bandeian, M. L., Sola, J. E., Karcutskie, C. A., ... Neville, H. L. (2018). Analysis of water sports injuries admitted to a pediatric trauma center: A 13-year experience. Pediatric Surgery International, 34(11), 1189–1193.

Camejo, L., Nandeesha, N., Phan, K., Chharath, K., Tran, T., Ciesla, D., & Velanovich, V. (2022). Infectious outcomes after splenectomy for trauma, splenectomy for disease and splenectomy with distal pancreatectomy. Langenbeck's Archives of Surgery, 407(4), 1685–1691.

Coccolini, F., Montori, G., Catena, F., Kluger, Y., Biffl, W., Moore, E. E., ... Ansaloni, L. (2017). Splenic trauma: WSES classification and guidelines for adult and pediatric patients. World Journal of Emergency Surgery, 12, 40.

Dickinson, C. M., Vidri, R. J., Smith, A. D., Wills, H. E., & Luks, F. I. (2018). Can time to healing in pediatric blunt splenic injury be predicted? Pediatric Surgery International, 34(11), 1195–1200.

Echavarria Medina, A., Morales Uribe, C. H., Echavarria, R. L. G., Vélez Marín, V. M., Martínez Montoya, J. A., & Aguillón, D. F. (2017). [Associated factors to non-operative management failure of hepatic and splenic lesions secondary to blunt abdominal trauma in children]. Revista Chilena de Pediatría, 88(4), 470–477.

Gates, R. L., Price, M., Cameron, D. B., Somme, S., Ricca, R., Oyetunji, T. A., Guner, Y. S., Gosain, A., Baird, R., Lal, D. R., Jancelewicz, T., Shelton, J., Diefenbach, K. A., Grabowski, J., Kawaguchi, A., Dasgupta, R., Downard, C., Goldin, A., Petty, J. K., ... Williams, R. (2019). Non-operative management of solid organ injuries in children: An American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee systematic review. Journal of Pediatric Surgery, 54(8), 1519–1526.

Goedecke, M., Kühn, F., Stratos, I., Vasan, R., Pertschy, A., & Klar, E. (2019). No need for surgery? Patterns and outcomes of blunt abdominal trauma. Innovative Surgical Sciences, 4(3), 100–107.

Harfouche, M. N., Dhillon, N. K., & Feliciano, D. V. (2022). Update on nonoperative management of the injured spleen. American Surgeon, 88(11), 2649–2655.

Holmes, J. F., Than, M. P., Harrison, B., & et al. (2012). Does microscopic hematuria after blunt trauma predict solid organ injury? Annals of Emergency Medicine, 60(3), 286–292.

Jiang, Q., Asha, S. F., Keady, J., & Curtis, K. (2017). Position of the abdominal seat belt sign and its predictive value for intra-abdominal injury in adult blunt trauma patients. Injury, 48(12), 2704–2708.

Kohler, J. E., & Chokshi, N. K. (2016). Management of abdominal solid organ injury after blunt trauma. Pediatric Annals, 45(7), e241–e246.

Lippert, S. J., Hartin, C. W., Ozgediz, D. E., Glick, P. L., Caty, M. G., Flynn, W. J., & Bass, K. D. (2013). Splenic conservation: Variation between pediatric and adult trauma centers. Journal of Surgical Research, 182(1), 17–20.

Liu, S., Bowman, S. M., Smith, T. C., & Sharar, S. R. (2015). Trends in pediatric spleen management: Do hospital type and ownership still matter? Journal of Trauma and Acute Care Surgery, 78(5), 935–942.

Lynch, J. M., Kilgar, J., & Al Shibli, A. (2018). Pediatric abdominal trauma. Current Pediatric Reviews, 14(1), 59–63.

Mader, M. M., Lefering, R., Westphal, M., Maegele, M., & Czorlich, P. (2022). Traumatic brain injury with concomitant injury to the spleen: Characteristics and mortality of a high-risk trauma cohort from the TraumaRegister DGU®. European Journal of Trauma and Emergency Surgery, 48(6), 4451–4459.

Nishijima, D. K., Simel, D. L., Wisner, D. H., & Holmes, J. F. (2012). Does this adult patient with blunt intra-abdominal injury have a blunt intra-abdominal injury? JAMA, 307(14), 1517–1527.

Notrica, D. M., Eubanks, J. W., Tuggle, D. W., Maxson, R. T., Letton, R. W., Garcia, N. M., Alder, A. C., Lawson, K. A., St Peter, S. D., Megison, S., & Garcia-Filion, P. (2015). Nonoperative management of blunt liver and spleen injury in children: Evaluation of the ATOMAC guideline using GRADE. Journal of Trauma and Acute Care Surgery, 79(4), 683–693.

Olthof, D. C., Joosse, P., van der Vlies, C. H., van der Naalt, J., de Jongh, M. A., & van der Laan, L. (2017). The value of computed tomography in the diagnosis of blunt splenic injury: A systematic review. Injury, 48(12), 2697–2703.

Podda, M., De Simone, B., Ceresoli, M., Virdis, F., Favi, F., Wiik Larsen, J., Coccolini, F., Sartelli, M., Pararas, N., Beka, S. G., Bonavina, L., Bova, R., Pisanu, A., Abu-Zidan, F., Balogh, Z., Chiara, O., Wani, I., Stahel, P., Di Saverio, S., ... Catena, F. (2022). Follow-up strategies for patients with splenic trauma managed non-operatively: The 2022 World Society of Emergency Surgery consensus document. World Journal of Emergency Surgery, 17(1), 52.

Schnüriger, B., Inaba, K., Barmparas, G., Eberle, B. M., Lustenberger, T., Lam, L., Talving, P., & Demetriades, D. (2010). Serial white blood cell counts in trauma: Do they predict a hollow viscus injury? Journal of Trauma, 69(2), 302–307.

Sola, J. E., Allen, C., Karcutskie, C. A., Perez, E. A., Lineen, E. B., Hogan, A. R., & Neville, H. L. (2017). Contemporary management of pediatric blunt splenic injury: A review. Journal of Pediatric Surgery, 52(12), 2065–2071.

Wesson, D. E. (2012). Pediatric trauma centers: Coming of age. Texas Heart Institute Journal, 39(6), 871–873.

Williams, R. F., Grewal, H., Jamshidi, R., Naik-Mathuria, B., Price, M., Russell, R. T., Vogel, A., Notrica, D. M., Stylianos, S., & Petty, J. (2023). Updated APSA guidelines for the management of blunt liver and spleen injuries. Journal of Pediatric Surgery, 58(8), 1411–1418.

World Society of Emergency Surgery. (2022). WSES consensus document on splenic trauma. World Journal of Emergency Surgery, 17(1), 1–15.

Yang, K., Li, Y., Wang, C., Xiang, B., Chen, S., & Ji, Y. (2017). Clinical features and outcomes of blunt splenic injury in children: A retrospective study in a single institution in China. Medicine (Baltimore), 96(51), e9419.

Zarzaur, B. L., & Rozycki, G. S. (2017). An update on nonoperative management of the spleen in adults. Trauma Surgery & Acute Care Open, 2(1), e000075.


View Dimensions


View Plumx


View Altmetric



0
Save
0
Citation
26
View
0
Share