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Blunt Splenic Trauma Outline

Blunt trauma to the spleen occurs when the spleen is subjected to a significant impact from an external source. These sources vary from knife wounds, gunshots, falls, and automobile accidents. The consequence of this trauma is a ruptured spleen, which has serious implications and can be fatal if left unattended and thus, needs to be treated immediately.

Before we talk about blunt splenic trauma, let’s understand the anatomy and function of the spleen.

Where is the Spleen Located and What Is Its Function?

You’d find the spleen in the top right quadrant of your abdomen. It sits well behind the rib cage and is protected by 9-12th ribs. The spleen has many important functions – these include removing and filtering red blood cells that don’t function well. The spleen also helps catch bacteria and produce antibodies, making it an essential part of our bodies. The main blood supply source of the spleen is the splenic artery.

What Happens in the Case of Blunt Trauma to the Spleen?

The symptoms of a ruptured spleen vary based on the injury or impact caused. While some patients complain of unexplained pain in the upper left quadrant, others with a major impact typically report major hemorrhage. Depending on the extent of the injury, the patients can be broadly classified into two categories – hemodynamically stable and hemodynamically unstable. The patient is categorized into either of the categories based on their vital signs, such as blood pressure and heart rate.

An experienced trauma surgeon can quickly identify the extent of the trauma caused due to the injury with the help of a CT scan or an ultrasound if required. Exploratory laparotomy is also opted for in cases of severe hemorrhage, but the probability of an exploratory laparotomy is rare. Depending on the severity of the trauma, the patient needs to be observed in the ICU (or general ward). The vitals of the patient needs close monitoring, along with a series of blood tests and abdominal examinations.

How Is Blunt Splenic Trauma Treated?

The splenic trauma is either operated upon or managed non-operatively – the call for the line of treatment is always taken by the trauma surgeon considering different factors such as the nature of the splenic injury, its evolution, and various tests results. The surgeon needs to be prepared 24/7 to operate on the patient in case bleeding persists. In some cases, bleeding recurs after a period of stability, and in such scenarios, too, surgeons operate on the patient.

The surgery for removing the spleen is known as ‘splenectomy,’ which has been the traditional line of treatment for blunt trauma to the spleen. Newer, lesser invasive treatments include embolization and blocking the hemorrhaging blood vessels. The ruptured spleen can be repaired with these non-operative measures, but splenectomy is still the primary surgical treatment. Despite all the new measures, splenectomy remains one of the most preferred and successful lines of treatment for blunt splenic trauma.

Both lines of treatment come with their own risks and complications. During operative procedures, the probability of damage to the peripheral organs is high, which may lead to additional issues. These non-operative procedures come with a risk of delayed bleeding, which ultimately leads to the trauma surgeon opting for splenectomy.

Only skilled trauma surgeons like Doctor Jay Johannigan can treat blunt splenic injuries in a skilled manner. With 40 years of experience, this trauma and critical care surgeon studied medicine with a Post Doctorate in Trauma and Critical Care. He has also been part of the Cincinnati-trained elite Air Force medical teams. Every patient under his care is treated with the utmost skill, leading to thousands of lives saved. For his work in the field, Dr. Jay Johannigan has also received numerous awards and recognition in the field of trauma care. 

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