{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:10:10Z","timestamp":1756368610321,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,16]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Non-operative management is the standard of care for blunt spleen trauma in stable patients in the absence of other abdominal injuries. This is a case report of a male patient in his 60s who presented to the emergency room with abdominal pain 2\u2009days after sustaining blunt abdominal trauma. The patient was haemodynamically stable, and CT scan revealed a severe spleen injury. Considering the clinical stability, the patient was admitted for non-operative management and kept under continuous monitoring. A CT angiogram revealed active bleeding, so the patient underwent angioembolisation of the distal splenic artery. Follow-up after angioembolisation was uneventful, and imaging findings were stable, so the patient was discharged after 12 days. Non-operative management is a valid option for stable patients, avoiding surgical complications while preserving spleen function. Being a dynamic process, it should be an option in centres with continuous monitoring capacity and emergency surgery availability, considering the potential failure of this approach.<\/jats:p>","DOI":"10.1136\/bcr-2024-263908","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T11:56:29Z","timestamp":1738065389000},"page":"e263908","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Standard of care for blunt spleen trauma: embracing non-operative management"],"prefix":"10.1136","volume":"18","author":[{"given":"Maria In\u00eas","family":"Reis","sequence":"first","affiliation":[{"name":"Surgery, Hospital de Vila Franca de Xira, Vila Franca de Xira, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3976-238X","authenticated-orcid":false,"given":"Ant\u00f3nio","family":"Gomes","sequence":"additional","affiliation":[{"name":"Surgery - Cirurgia B, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernardo","family":"Patr\u00edcio","sequence":"additional","affiliation":[{"name":"Surgery, Hospital de Vila Franca de Xira, Vila Franca de Xira, Lisboa, Portugal"},{"name":"Surgery, Centro Hospitalar do Oeste - unidade de Torres Vedras, Torres Vedras, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V\u00edtor","family":"Nunes","sequence":"additional","affiliation":[{"name":"Surgery, Hospital de Vila Franca de Xira, Vila Franca de Xira, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"key":"2025082800475517000_18.1.e263908.1","doi-asserted-by":"crossref","DOI":"10.1186\/s13017-017-0151-4","article-title":"Splenic trauma: WSES classification and guidelines for adult and pediatric patients","volume":"12","author":"Coccolini","year":"2017","journal-title":"World J Emerg Surg"},{"key":"2025082800475517000_18.1.e263908.2","doi-asserted-by":"crossref","DOI":"10.1186\/s13017-019-0249-y","article-title":"Non-operative management of blunt hepatic and splenic injury: a time-trend and outcome analysis over a period of 17 years","volume":"14","author":"Fodor","year":"2019","journal-title":"World J Emerg Surg"},{"key":"2025082800475517000_18.1.e263908.3","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000154575.49388.74"},{"key":"2025082800475517000_18.1.e263908.4","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1177\/000313480006600707","article-title":"Nonoperative management of blunt splenic injury in adults 55 years and older: a twenty-year experience","volume":"66","author":"Krause","year":"2000","journal-title":"Am Surg"},{"key":"2025082800475517000_18.1.e263908.5","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200105000-00010"},{"key":"2025082800475517000_18.1.e263908.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2005.03.037"},{"key":"2025082800475517000_18.1.e263908.7","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182702afc"},{"key":"2025082800475517000_18.1.e263908.8","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1177\/000313480206800303","article-title":"Nonoperative management of blunt splenic injuries: factors influencing success in age >55 years","volume":"68","author":"Albrecht","year":"2002","journal-title":"Am Surg"},{"key":"2025082800475517000_18.1.e263908.9","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.140.6.563"},{"key":"2025082800475517000_18.1.e263908.10","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1177\/000313480707300610","article-title":"Nonoperative management of blunt splenic trauma in the elderly: does age play a role?","volume":"73","author":"Siriratsivawong","year":"2007","journal-title":"Am Surg"},{"key":"2025082800475517000_18.1.e263908.11","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1016\/j.jpedsurg.2023.03.012","article-title":"Updated APSA Guidelines for the Management of Blunt Liver and Spleen Injuries","volume":"58","author":"Williams","year":"2023","journal-title":"J Pediatr Surg"},{"key":"2025082800475517000_18.1.e263908.12","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1007\/s00268-021-06063-x","article-title":"Post-traumatic Splenic Injury Outcomes for Nonoperative and Operative Management: A Systematic Review","volume":"45","author":"Gill","year":"2021","journal-title":"World J Surg"},{"key":"2025082800475517000_18.1.e263908.13","doi-asserted-by":"crossref","unstructured":"Alomar Z , Alomar Y , Mahmood I , et al . 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