Patients with unexplained left upper quadrant pain, particularly if there is evidence of hypovolemia or shock, are generally inquired regarding any recent trauma.

[1] Blunt splenic trauma most often occurs in automobile accident victims, in which it is a leading cause of internal bleeding.

An exploratory laparotomy is an opportunity to assess the four quadrants of the abdomen and to look at the bowel for any perforations, vascular injuries, or abnormalities.

[2] A set of CT scan grading criteria was created to identify the need for intervention (surgery or embolization) in patients with splenic injury.

The criteria were established using 20 CT scans from a database of hemodynamically stable patients with blunt splenic injury.

Most small, and some moderate-sized lacerations in stable patients (particularly children) are managed with hospital observation and sometimes transfusion rather than surgery.