Surgical Intervention in Splenic Emergencies: Indications and Outcomes

Background: Splenic injuries are common in blunt abdominal trauma and present a management challenge balancing operative and non-operative approaches and in our study we evaluates indications for surgical intervention, postoperative outcomes, and risk factors in patients with splenic emergencies however method of our study was A retrospective analysis was conducted on 110 patients with splenic trauma managed at a tertiary trauma center also Demographic data, injury characteristics, management strategies, surgical procedures, complications, mortality, and hospital stay were analyzed. Injury severity was classified by the American Association for the Surgery of Trauma (AAST) grading system. Logistic regression and chi-square analyses identified risk factors associated with complications and mortality, where the results in our study were that the cohort was predominantly young males (81.8%) with blunt trauma (96.5%). Emergency laparotomy was performed in 54 patients (49%), primarily indicated by grade IV injury (68.5%) and hemodynamic instability (31.5%). Splenectomy accounted for 70.4% of surgeries. Postoperative complications occurred in 18.5% of laparotomy cases, predominantly infectious in the splenectomy group (70%). Mortality was low (0.9%). In addition to Logistic regression, younger age (<54 years), male sex, higher injury severity (ISS ≥16), and congestive heart failure as significant independent risk factors for complications. Chi-square analysis confirmed a significant association between splenectomy and increased infectious and severe complications (p<0.01). Finally, non-operative management is safe and effective in hemodynamically stable patients with low to moderate splenic injuries, while surgical intervention remains essential for high-grade injuries and unstable patients.