[Conservative treatment for trauma of the spleen in adults. Comparative study of thirty-four cases of conservative treatment and sixty-one cases of splenectomy].

Between 1983 and 1990, 95 patients with abdominal injury and splenic damage underwent surgery. Conservative treatment was performed in 34 cases (group I) and splenectomy was performed in 61 cases (group II). In group I, one patient died and post-operative complications occurred in 18 patients (53%). In group II, 3 patients died (of a 0hrenic abscess for one of them), and postoperative complications occurred in 38 patients (62%). There was no significant difference between group I and group II in terms of length of hospital stay and operation time; but a greater number of red cell concentrates was required during the operation in group II. No patient of group I developed post-operative infection during the mean interval of 18 months. This experience confirms that the conservative treatment of splenic contusions does not worsen the prognosis of abdominal injuries. Medium and long term infectious complications might be prevented by the conservative treatment but it is still too early to assess the real benefit of this option.