Their risk for developing OPSI is about 175 times that of the general population. As a result, splenorraphy is often attempted when splenic injury is identified at laparotomy. In the last few decades, the CT scan has become invaluable as a tool in evaluating suspected abdominal trauma. Since some laparotomies were shown to be positive but nontherapeutic, traumatologists investigated nonoperative management of splenic injuries identified and graded by CT scan. The goal was to avoid nontherapeutic laparotomies.
Data now supports the role of nonoperative management of splenic injuries.
Important considerations include hemodynamic stability of the patient, overall and baseline physiologic status. Hemothorax can also be detected sonographically. However, free abdominal fluid may be missing in the initial examination, especially if the patient is in shock. A repeat exam may be indicated within the first hour to re-evaluate for free fluid or an expanding subcapsular hematoma. This exam may be performed while the patient is undergoing CT of the head or other procedures.