INTERVENTIONS IN THE TREATMENT OF GRADE IV AND V SPLENIC LESIONS IN BLUNT ABDOMINAL TRAUMA: ANGIOEMBOLIZATION OR SPLENECTOMY

Abstract

Introduction: The spleen is the organ most affected in blunt abdominal trauma and performs important immunological activities. Objective: To synthesize the most current approaches for the treatment of severe splenic lesions in blunt abdominal trauma, addressing conservative and surgical treatments, in addition to highlighting the need for each of the approaches, and comparing their respective complications. Methodology: This integrative review was carried out in the PubMed, SciELO, and VHL databases, searching for articles published between 2019 and 2024. The DeCS/MeSH and Rayyan tools were used to collaborate in the creation and organization of the research. The selection of articles was carried out in a double-blind manner, of which they were systematic reviews, observational studies, literature reviews, and randomized studies. Results: Initially, 371 articles were found in the three databases used. After removing 145 duplicates and 41 studies that met the exclusion criteria, 185 articles remained for double-blind evaluation. After reading the title, abstract, and introduction, 120 articles were excluded. In total, 65 articles were read in full, of which 51 were excluded due to lack of relevance to the research. In the end, 14 articles were selected, including systematic reviews, observational studies, literature reviews, and randomized studies. Conclusion: Conservative management preserves the immune function of the spleen, in addition to reducing other complications. Although splenectomy is currently preferable over angioembolization of the splenic artery in severe cases, there are indications that show the possibility of conservative management in high-grade lesions.