Splenic traumas: indications and limitations of conservative treatment

According to the experience of the authors, comparison between two consecutive periods (1980-1994 and 1995-2000) has shown a substantial increase in splenic traumas simply treated by observation and monitoring. Their number in fact has risen significantly from 5 to 32. This has allowed a rise in the overall percentage of spleen conservation, which has increased from 16.4% to 52.9%. On the contrary, a reduction in surgical conservative operations has been observed, the number decreasing from 19 to 4. Such treatments require the same clinical conditions as non- operative treatments, but the latter have to be accompanied by efficient organization of intensive care and monitoring, in which surgeons and anesthesists, who are familiar with all the aspects of the problem, collaborate efficiently. Since this kind of organization has been achieved, the number of patients successfully treated without surgery has increased significantly. In a sample of 37 patients receiving non-surgical conservative treatment, the percentage of delayed splenectomies was as low as 5.4%.