MAIN CONTROVERSIES IN THE NONOPERATIVE MANAGEMENT OF BLUNT SPLENIC INJURIES.
BACKGROUND
The nonoperative management of traumatic spleen injuries is the modality of choice in patients with blunt abdominal trauma and hemodynamic stability. However, there are still questions about the treatment indication in some groups of patients, as well as its follow-up.


OBJECTIVE
Update knowledge about the spleen injury.


METHODS
Was performed review of the literature on the nonoperative management of blunt injuries of the spleen in databases: Cochrane Library, Medline and SciELO. Were evaluated articles in English and Portuguese, between 1955 and 2014, using the headings "splenic injury, nonoperative management and blunt abdominal trauma".


RESULTS
Were selected 35 articles. Most of them were recommendation grade B and C.


CONCLUSIONS
The spleen traumatic injuries are frequent and its nonoperative management is a worldwide trend. The available literature does not explain all aspects on treatment. The authors developed a systematization of care based on the best available scientific evidence to better treat this condition.
School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil.
Jorge Roberto Marcante
JR
Carlotto
School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil.
Gaspar de Jesus
Gde J
Lopes-Filho
School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil.
Ramiro
R
Colleoni-Neto
D003663:Decision Trees; D006801:Humans; D017410:Practice Guidelines as Topic; D013154:Spleen / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000628:therapy*