Primary splenectomy for major splenic injury?

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In a message dated 4/10/2006 11:23:36 P.M. Eastern Standard Time,  
karim at trauma.org writes:

Recently  there have been a few reports of significant complication rates and 
long  hospital stays from non-operative management of
the more severe grades of  splenic injury (I'm thinking mainly of David 
Feliciano's review at the  AAST).  

So as a general question - should we be retuning to  primary splenectomy in 
the patient who would otherwise be suitable  for
non-operative management but who has a major splenic injury (and what  would 
you class as major)?

Karim


STABLE PATIENT, MAJOR INJURY
PROXIMAL SPLENIC ARTERY EMBOLIZATION IS AS EFFECTIVE AS SPLENECTOMY WITH  
LESS TRANSFUSION AND LESS MORBIDITY
SAL

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