Ruptured spleen: treatment without surgery
Sometimes a ruptured spleen can be treated without surgery. Conservative treatment is an option under the following conditions:
- The circuit is sufficiently stable.
- It is a blunt and single spleen injury.
- The spleen capsule is still intact.
- Appropriate medical supervision and care is possible.
As a rule, doctors administer fluids to their patients via the vein. Then they actively wait and check the spleen rupture at close intervals. A stay in hospital is therefore necessary.
Treatment without surgery has the advantage that no abdominal incision (laparotomy) is necessary – this is associated with some risks, such as infections. Healing also takes longer and you need more time to recover. In addition, the function of the spleen as an immunological organ is preserved.
Ruptured spleen: Treatment with surgery
The operation is usually performed via an abdominal incision (laparotomy). Trauma surgeons try to preserve the spleen and stop the bleeding using various techniques, especially in children and adolescents. This procedure to stop bleeding is called splenorrhaphy. The following options are available:
- Coagulation (e.g. with infrared)
- Laser
- Sewing
- Tissue adhesive (fibrin glue)
- Collagen fleece
- Resorbable plastic mesh that encases and compresses the organ
In the case of severe splenic ruptures, parts of the spleen(partial resection) are removed using a laser, ultrasonic scalpel or knife and clamps. Sometimes it is not possible to preserve the organ and the entire spleen(splenectomy) is removed as part of the surgical procedure.
In selected cases, the supplying vessel (lienal artery) can be closed by means of a catheter inserted from the groin in order to preserve the spleen. This massively reduces the risk of bleeding.