Blunt splenic trauma: diagnosis and management.

To examine the morbidity and mortality associated with blunt splenic injuries, the authors reviewed the results in 106 such patients treated in the Sunnybrook Regional Trauma Unit between June 1, 1976 and June 30, 1983. Initial assessment included peritoneal lavage in 86 patients. No patient with known or suspected splenic injury was treated nonoperatively nor were any patients found to have had splenic injuries missed at the initial assessment. Seventy-one splenectomies and 35 splenorrhaphies were performed. The overall mortality was 25% and 10 surviving patients had serious complications. The splenic injury itself was never the cause of death. Only one patient who initially underwent splenorrhaphy later required splenectomy. It is concluded that blunt splenic injury is rarely the cause of death or serious morbidity when a policy of immediate diagnosis and operative treatment is carried out. Furthermore, in selected patients, splenorrhaphy is a safe and effective treatment.