A comparison of case series comparing Non Operative Management vs Operative Management of splenic injury after blunt trauma.

Background
Spleen is the most easily injured organ in abdominal traumas. Several reports about successful non-operative management and modern diagnostic imaging have progressively allowed the diffusion of a conservative approach.
The aim of our retrospective study was to compare Non Operative Management with surgery.
Methods
We compared seven patients subjected to NOM, between 2007 and 2011, with six patients undergoing OM with similar preoperative characteristics.
Results
Average hospital stay was lower in NOM group than in patients with OM, although not statistically significant. NOM group required significantly fewer transfusions, and no patient in this group, necessitated a period of intensive care unit stay, while 83% of patients recovering from OM needed it. The failure rate of NOM was in our experience 14.3%.
Conclusions
In our experience, NOM was the treatment of choice, thanks to several advantages, in blunt splenic injuries grade I, II and III. NOM is slightly less than surgery, but this is an unadjusted comparison and the 95% confidence interval is extremely wide - from 0.04 to 16.99. Splenectomy was the chosen technique in patients with exclusion criteria for NOM, as well as in those with grade IV and V injury.