Depending on the overall clinical situation, conservative therapy of splenic rupture up to and including severity type 3 (see “Classification” below) is attempted in hemodynamically stable patients to avoid postsplenectomy syndrome (OPSI syndrome). If surgery is required, it should be spleen-preserving.
The following procedures are used for splenic preservation in peripheral ruptures:
- Oversewing
- Laser or infrared coagulation (heat coagulation).
- Fibrin glue (fibrin glue)
- Vascular ligatures (vascular underbonds)
- Organ spanning absorbable plastic mesh for compression.
- Partial splenic resection (surgical removal of part of the spleen), if necessary.
From severity type 4 (organ fragmentation), an immediate splenectomy (surgical removal of the entire spleen), if necessary, also a splenic partial resection, is required.
Note after splenectomy has been performed:
- In 1-5% of cases, there is a risk of postsplenectomy syndrome (OPSI syndrome, overwhelming postsplenectomy infection syndrome; foudroyant sepsis (blood poisoning)).
- Postoperatively, a pneumococcal vaccination must be given immediately. This is an indication vaccination for risk groups (here. Asplenia / missing spleen). Duration of vaccination protection individually very different, about 3-5 years!
