ABSTRACT
Injury to the spleen is common, resulting in a significant number of hospital admissions, morbidity, and occasionally death. The spleen is the second most commonly injured organ in blunt abdominal trauma and the most common reason for laparotomy after blunt injury. Selective NOM of blunt splenic injuries has become standard for hemodynamically stable patients and those who respond rapidly to initial resuscitation (responders). The minimal criteria for NOM of blunt spleen injuries have been identified as hemodynamic stability and the absence of generalized peritonitis in the setting of a reliable and reproducible exam. As the role of NOM in penetrating abdominal injuries has increased in general, the rate of successful NOM in penetrating splenic injuries has increased as well. Splenic artery embolization (SAE) has become an important adjunct in patients at the highest risk for NOM failure. The focused abdominal sonography for trauma (FAST) exam is generally the initial imaging study performed for blunt trauma patients.
