TY - CHAP M1 - Book, Section TI - Splenic Conservation A1 - Ellison, E. Christopher A1 - Zollinger, Jr., Robert M. A1 - Pawlik, Timothy M. A1 - Vaccaro, Patrick S. A1 - Bitans, Marita A1 - Baker, Anthony S. Y1 - 2022 N1 - T2 - Zollinger’s Atlas of Surgical Operations, 11e AB - Injury to the spleen is one of the more serious problems associated with trauma. Serious splenic injury can lead to emergent possible exsanguination. Splenectomy, however, confers a small but measurable risk of catastrophic bacterial infection with encapsulated organisms such as pneumococci, especially in children, for the remainder of the patient’s life. This risk has stimulated clinicians to conserve the spleen with or without operation. Nonoperative treatment in children and adults is often successful if careful monitoring is provided in hospital and thereafter at home until full healing is documented. In addition, angiographic embolization may be used to control splenic bleeding. In adults as well as in children, splenorrhaphy is often possible because it is desirable to salvage as much of the traumatized spleen as possible. It is uncertain how much retained spleen is essential to provide normal protection for patients, but many surgeons recommend preservation of half or more if possible. The surgeon must appreciate that it is essential to control exsanguination and that total splenectomy should be performed for splenic fractures that are massive or that cannot be easily controlled in the presence of continued major hemorrhage. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1187822757 ER -