Original Investigation

Outcomes of Isolated Severe Blunt Splenic Injury

JAMA Network Open 10.1001/jamanetworkopen.2025.33266

September 23, 2025 at 11:00 AM EDT

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What is the optimal approach to managing severe splenic injuries?In this cohort study of 7567 patients, nonoperative management (angioembolization or observation) was associated with favorable outcomes when compared with surgery in isolated severe blunt splenic injury, even in patients with hypotension on admission.This study’s results suggest that with careful patient selection, nonoperative management and splenic salvage may be possible and preferred even in high-grade splenic injuries.

Corresponding Author: Demetrios Demetriades, MD, PhD, Division of Trauma and Acute Care Surgery, Department of Surgery, Los Angeles General Medical Center, 2051 Marengo St, IPT C5L100, Los Angeles, CA 90033 (demetria@med.usc.edu).

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