A 30-year-old man sustains blunt abdominal trauma in a road traffic accident. CT abdomen shows a grade V splenic injury (shattered spleen with hilar vascular devascularisation). He is hemodynamically stable after initial resuscitation. What is the definitive management?
- A Splenectomy ✓
- B Splenorrhaphy with mesh wrap
- C Angioembolisation of the splenic artery
- D Conservative management with bed rest and serial hemoglobin monitoring
Correct answer: A. Splenectomy
Explanation
Grade V splenic injury involves shattered spleen or hilar devascularisation, which is not amenable to repair or conservative management. Splenectomy is the definitive treatment for grade V injuries. Angioembolisation and conservative management are options for lower-grade injuries (I to III, select IV) in hemodynamically stable patients.
Reference: Schwartz's Principles of Surgery, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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