Splenorrhaphy. The alternative

Ann Surg. 1990 May;211(5):569-80; discussion 580-2. doi: 10.1097/00000658-199005000-00007.


From 1980 to 1989, 240 adult patients underwent splenorrhaphy at one urban trauma center. This represents 43.4% of all splenic injuries seen during this time interval. Splenic injuries were graded I to V, and splenorrhaphy was attempted except when the spleen was shattered or when multiple injuries with associated hypotension were present. Penetrating wounds, blunt trauma, or iatrogenic/unknown etiologies were present in 54.2%, 41.6%, and 4.2% of patients, respectively. Grade I or II injuries were present in 51.7% of patients, grade III in 34.6%, grade IV or V in 9.6%, and unknown grade in 4.1%. The technique of splenorrhaphy was simple suture (usually chromic) with or without the addition of topical hemostatic agents in 200 patients (83.3%), topical agents alone in 12 (5%), unknown type of repair in 12 (5%), compression, cautery, or nonbleeding injury in 9 (3.8%), and partial or hemisplenectomy in 7 (2.9%). Postoperative rebleeding occurred in three patients (1.3%) with grade II, III, and IV injuries, respectively, and led to splenectomy at reoperation. In another patient who had a hemisplenectomy performed for a grade IV injury, subphrenic abscesses and septic shock led to the death of the patient. Splenorrhaphy can be safely performed in properly selected adult patients after a variety of injuries. The risk of rebleeding is practically nil when the spleen is fully mobilized and visualized during repair.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Female
  • Humans
  • Iatrogenic Disease
  • Male
  • Postoperative Complications
  • Spleen / diagnostic imaging
  • Spleen / injuries
  • Spleen / surgery*
  • Splenectomy
  • Sutures
  • Tomography, X-Ray Computed
  • Trauma Centers
  • Wounds, Nonpenetrating / surgery
  • Wounds, Penetrating / surgery