الفهرس 
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Abstract
The spleen is the most frequently injured organ in blunt abdominal trauma, mainly because of its highly vascularized parenchyma and its anatomical location (1).
In the past the management of blunt splenic injuries was splenectomy , but high rate of operative complications caused paradigm shift from operative to non-operative management (NOM) in hemodynamically stable blunt abdominal trauma patients (15).
Now, non-operative management of hemodynamically stable patients with blunt splenic injuries is the standard of care and has been proven to be safe and successful in the acute setting (44).
NOM can be safely practiced in a Trauma Care Centre which has Trauma Surgeons, newer imaging modalities, High Dependency Unit (HDU), ICU and other supporting services (102).
The advent of newer imaging techniques with high resolution CT scanners has enabled the clinicians to exactly diagnose the extent of intra-abdominal organ injury. (135).
Aim of the work is to discuss different treatment modalities in traumatic splenic injuries and to differentiate between cases of splenic injuries that indicate splenectomy , cases which can be managed by splenorrhaphy , partial splenectomy and others that require only conservative management, so avoiding the risk of surgical interference, massive blood transfusion and post splenectomy infections caused by H. Influenza, streptococcus pneumonie and nisseria meningitides especially in young age.
In this study, bunt splenic injury was found to be more common in males because of they are more active and because of their risky work. RTA and Falling from a height were found to be the most common causes of blunt abdominal injuries. FAST scan is rapid, non-invasive, accurate technique can be performed during resuscitation for assessment of haemoperitoneum, but CT scan is the standard of care in the evaluation of splenic trauma. According to CT, grade one and two of splenic injury are more common than other grades of splenic injury.
As regard blood transfusion, operative management of splenic injury requires more blood transfusion than conservative management, as all patients who managed operatively need blood transfusion while in the second group who managed conservatively only one third of patients need blood transfusion. As regard hospital stay the result was nearly equal, about6 days in conservative treatment and about 7 days in operative treatment.
As regard complication the operative management has more complication as postoperative wound infection, postoperative chest infection. So, NOM of splenic injury is the management of choice in haemodynamically stable patients.