The Path ˝Between Scylla and Charybdis˝ in the Non-Operative Management of Blunt Splenic Injuries (Using the Example of Three Clinical Cases)

Abstract. Non-operative management of blunt splenic injuries in hemodynamically stable patients is accompanied by fewer complications and low mortality. At the same time, it is very important to select patients correctly and dynamically monitor their condition for timely treatment correction. Aim of the Study. was to demonstrate three possible scenarios for the development of the situation when choosing the initially non-operative management of patients with combined blunt splenic injuries. Material And Methods. The clinical observations of three patients with combined blunt splenic injuries who were treated at the 3rd-level trauma center of the Volgograd City Clinical Emergency Hospital No. 25 in 2024 are presented. The initially planned non-operative management was supplemented or transformed in two cases. Results. Non-operative management of blunt splenic injuries is the method of choice in hemodynamically stable patients in the absence of other indications for surgery and the possibility of careful dynamic monitoring. Conclusion. Proper selection of patients with splenic injuries for non-operative management and their dynamic monitoring, supplemented by angioembolization, if necessary, make it possible in most cases to achieve success, which is accompanied by fewer complications and low mortality. With the development of hemodynamic instability and an increase in hemoperitoneum, a laparotomy splenectomy is the surgery of choice.