F.K. Wilson1,2, A. Karchner1, S. Ahmed1, R.E. Heidel1, A. Cavalea1, J. Griepentrog1 1University of Tennessee Graduate School of Medicine, Department Of Surgery, Knoxville, TN, USA 2University of Tennessee Health Science Center, College Of Medicine, Memphis, TN, USA
Introduction: Splenic injuries are common in blunt abdominal trauma patients. Management options include splenectomy, angioembolization, and observation. The spleen has an important role in immune function, especially against encapsulated bacteria. Splenectomy has been shown to cause an altered cellular immune response and is an independent risk factor for early infectious complications. Previous studies suggest that these immune changes persist for years after splenectomy, leaving patients at risk for infection. Due to the potential morbidity and mortality associated with splenectomy, splenic artery embolization is an accepted method for preserving splenic function in blunt splenic injury patients.
Methods: We completed a retrospective, single-center study analyzing all patients with grade 3-5 splenic lacerations from 2017-2023. A total of 277 patients were included. Outcomes including major complications, infections, and immune cell changes were compared among the groups.
Results: Patients avoiding splenectomy had improved hospital outcomes and preserved immune function. Significant differences in platelet to white blood cell ratio, neutrophil count, length of hospital stay, and odds of survival were detected among the three groups.
Conclusion: Our data supports observation and splenic artery embolization in the management of hemodynamically stable splenic lacerations.