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

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