Management of splenic trauma in hemodynamically stable patients: Lessons to be drawn from the French SPLASH trial (Splenic Arterial Embolization to Avoid Splenectomy (SPLASH) Study Group).

• In cases of splenic trauma with hemodynamic stability, rate of splenic salvage is a major criterium for evaluation of the different practices (surveillance, radiological embolization or conservative surgery). • Taking into account recent advances in interventional radiology, some centers propose preventive embolization for the patients most at risk of secondary rupture, mainly those with grade IV–V trauma according to the American Association for the Surgery of Trauma classification. • The multicenter SPLASH randomized trial involved 133 stable patients at high risk of splenic rupture and compared the results of early preventive embolization with those of ulteriorly necessary embolization. While systematic embolization was not linked to heightened splenic salvage rate, it was associated with reduced length of hospital stay. The overall rate of SAE-related complications was 6%. • These results justify the proposal of prophylactic embolization in cases of OIS Grade IV–V splenic injury with hemodynamic stability. [ABSTRACT FROM AUTHOR]