Splenic Trauma: Preservation, Embolization and Life After Splenectomy

Splenectomy can stop hemorrhage quickly, but the decision does not end when the spleen is removed. This lecture follows the full pathway of splenic trauma management — from updated injury grading and CT evidence of active bleeding to observation, operative preservation and angioembolization.

The discussion goes beyond algorithms into the trade-offs surgeons face in practice: which patients belong in the operating room, what complications can follow embolization, how low- and high-grade injuries are monitored, and why post-splenectomy sepsis remains a lifelong concern. The immunology behind pneumococcal vaccination and the timing of vaccination after splenectomy are connected directly to clinical decision-making and follow-up.

The Q&A brings the topic into the realities of combat trauma and resource-limited care in Ukraine, including penetrating splenic injury, damage-control surgery, unreliable follow-up and the still-unsettled role of splenic reimplantation. Several of the most interesting questions sit exactly where evidence, physiology and battlefield logistics stop giving an easy answer.