Many patients with blunt splenic injuries may be safely managed without surgery. However, a number of findings may indicate that non-operative management has or will fail and that surgery is needed.


Risk factors associated with a failure of non-operative management:

(1) persistent hemodynamic instability after initial resuscitation

(2) underlying disease within the spleen

(3) splenic trauma grade III to V

(4) hemoperitoneum on CT scan

(5) very young or very old (extremes of age)


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