Traumatic injuries to the spleen are common in emergency settings, often necessitating prompt intervention. However, in certain settings, urgent access to interventional radiology resources may not be readily available. This study aims to present our experience in managing splenic trauma within a surgical center lacking immediate access to interventional radiology

Material and Methods: Single-center, cohort retrospective study including 24 trauma patients with splenic injuries between may 2022 to october 2023 (17 months). Data were collected on mechanism of injury, associated lesions, time to intervention, surgical approach, and post-operative complications were analyzed

Results:Twenty-four patients (18 men) were included, with a median age of 52 years. The splenic injury occurred following blunt trauma due to motor vehicle collisions in 13 patients or falls in 9 patients. Most of the patients had other associated lesions (75%), such as thoracic or cranioencephalic trauma. 8 patients were submitted to emergent surgical approach, 3 to radiologic treatment and 13 under surveillance; of these, 4 were submitted to surgery. 8.3% of the patients had grade V splenic rupture, 20.8% grade IV, 16.7% grade III/IV, 29.2% grade III and 25% grade I or II. Splenectomy was performed in 12 patients and the spleen was preserved in 12 patients. In 1 patient other procedures were performed along with splenectomy. The median postoperative time was 11 days. 4 patients had some kind of complications, 2 Clavien-dindo II and 2 patients died during hospitalization

Conclusion: Spleen trauma can be a surgical emergency in blunt trauma patients and splenectomy is a procedure that should be performed when there is a life-threatening hemorrhage. Our study underscores the importance of adapting surgical strategies in cases of splenic trauma when immediate access to interventional radiology is unavailable. Our findings contribute valuable insights for trauma centers facing similar resource constraints.

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