Western Trauma Association
Management of Adult Blunt Splenic Trauma
Annotation
for Point F
Although the grade of splenic injury (Table
3) does correlate with success of NOM, it is not
accurate enough to predict failure or success in
individual patients.39,40
There is a selection bias in who gets a CT scan.
Patients with high grade injuries who are bleeding
profusely are triaged early to the OR based on grade of
instability and the results of the FAST examination.
Additionally, in blunt trauma the spleen tends to
fracture along the relatively avascular plains between
the segmental polar arteries. As a result, the severity
of the injury seems severe because there is a deep
laceration into the parenchyma but there is only limited
bleeding.
