Vol. 8, Issue 3, Part A (2024)

Background: The spleen is frequently injured following blunt abdominal trauma, with non-operative management (NOM) increasingly favored, especially in children and hemodynamically stable adults. However, controversy surrounds the use of NOM in higher-grade injuries, particularly in multi-trauma patients. This prospective study, conducted at Al-Imamain Al-Kadhumain Medical City from October 2020 to October 2022, aimed to evaluate the effectiveness of NOM in patients with blunt splenic injuries who were hemodynamically stable.

Methods:  Patients were classified into three groups based on their response to fluid administration: stable, transient responder, and unstable. NOM was applied to stable and transient responders regardless of injury severity, with close clinical and laboratory monitoring for 48-72 hours. Laparotomy was performed only in patients who became hemodynamically unstable during observation.

Results: Out of 100 patients treated with NOM, 92% experienced successful outcomes, while 8% required splenectomy due to NOM failure. Complications occurred in 23 cases, with most managed conservatively; however, one patient succumbed to sepsis.

Conclusion: The study concludes that NOM is an effective treatment option for blunt splenic injuries in stable or stabilizable patients, irrespective of lesion grade, according to the AAST Organ Injury Scale.