Splenic Injury
Traumatic damage to the spleen requiring urgent evaluation and possible surgical intervention.
Overview
Splenic injuries are common in blunt abdominal trauma (road accidents, falls, sports). The spleen is the most commonly injured abdominal organ. Modern management aims to preserve the spleen when possible (non-operative management) due to its important immune function.
Causes
- Blunt abdominal trauma (most common)
- Road traffic accidents
- Falls from height
- Sports injuries
- Iatrogenic (during surgery)
- Pathological rupture (malaria, infectious mononucleosis, splenomegaly)
Risk Factors
- Contact sports
- Two-wheeler accidents
- Splenomegaly (makes spleen more vulnerable)
- Anticoagulant use
Symptoms
Diagnosis
- FAST ultrasound (emergency — free fluid)
- CT abdomen with contrast (gold standard — grades injury I-V)
- Serial hemoglobin monitoring
- AAST grading system
Treatment Options
Surgical Treatment
Management depends on hemodynamic stability and injury grade. Stable patients with Grade I-III injuries: non-operative management (bed rest, monitoring, serial imaging) — successful in 80-90%. Unstable patients or Grade IV-V: splenectomy (laparoscopic if possible). Post-splenectomy: lifelong vaccination protocol (pneumococcal, meningococcal, H. influenzae).
Recovery
Non-operative: 2-5 days hospital stay, avoid contact sports for 3 months, serial imaging at 48-72 hours. Splenectomy: 3-5 days hospital stay, vaccines before discharge, lifelong infection awareness.
Prevention
- Seatbelt use
- Helmet for two-wheelers
- Protective gear in contact sports
- Avoid trauma to left upper abdomen in patients with splenomegaly
Frequently Asked Questions
Can I live without a spleen?
Will my spleen heal without surgery?
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