The World Society of Emergency Surgery has given guidance for the management of an adult with splenic trauma.
Patient selection: splenic trauma
Indications for laparotomy:
(1) hemodynamic instability
(2) transient responder to immediate resuscitation
(3) bowel evisceration
(4) impalement
(5) peritonitis
(6) other indications for laparotomy (positive FAST, other)
(7) ineffective angioembolization
Indications for angiography:
(1) WSES grade III
(2) WSES grade I, II or III on non-operative management who develops clinical instability
Indications for angioembolization:
(1) positive blush on angiography
(2) early aneurysmon angiography
Non-operative management (NOM) is indicated at a center with sufficient expertise:
(1) WSES Grade I or II
(2) WSES Grade III with effective angioembolization
