Laparoscopic partial splenectomy with modified Warshaw method for severe traumatic splenic rupture: a case report

BACKGROUND: The spleen is one of the most frequently damaged organs in abdominal trauma, which may lead to rapid hemodynamic instability and require emergency surgical intervention. With the development of interventional techniques, more and more splenic injuries can achieve good results through non-surgical treatment measures such as interventional therapy. However, for some patients with severely damaged spleens, surgery remains the preferred treatment. CASE PRESENTATION: This case report details the surgical treatment process of a 26-year-old male of Han Chinese ethnicity who suffered a grade IV splenic laceration following a motor vehicle accident. Due to the large area of splenic injury starting from the lower pole of the spleen and involving the splenic hilum, the patient underwent laparoscopic partial splenectomy, with the lower pole of the splenic tissue resected. Based on the ligation of the lower pole branches of the splenic artery and vein, to control the bleeding from the wound surface, the upper pole branch of the splenic artery was also ligated. Through the blood supply of the short gastric artery and the reflux of the splenic vein, the patient avoided total splenectomy. The patient recovered smoothly and was discharged after 10 days of hospitalization. CONCLUSION: The partial splenectomy method of artery resection and vein preservation introduced by us provides a feasible alternative for patients with severe splenic injuries involving the splenic hilum who need surgical treatment.