Non-Operative Management of Splenic Injury

Abstract

Background: Non-operative care has become the preferred option for the majority of patients with traumatic splenic injury who stay hemodynamically stable, regardless of injury severity. This method attempts to protect splenic immune function and avoid splenectomy complications while maintaining a high splenic salvage rate. Safe management requires appropriate patient selection, continuous clinical and hemodynamic monitoring, serial laboratory assessments, and prompt access to surgical and interventional radiology services. Although success rates are normally high, failure can occur in individuals with persistent hemodynamic instability, high-grade injuries, extensive hemoperitoneum, vascular anomalies, increased transfusion requirements, or related multiple-organ injuries. Splenic angioembolization has become a valuable treatment option for patients with active contrast extravasation, pseudoaneurysms, or other vascular abnormalities, increasing bleeding management and lowering the need for surgery. This mini-review examines the indications, contraindications, monitoring needs, activity limits, failure predictors, and role and potential complications of angioembolization in the non-operative treatment of traumatic splenic injury.