Tonight I was asked to see a 73 year-old woman, smoker with no
past history who presented after a fall on a staircase with LUQ pain.
She came to the ER in the morning of the 18th but was discharged with no
further investigation. Came back today (36 hours post injury) with
worsening pain, CT shows
grade IV-V splenic injury, no pooling of contrast, Hb 94, pulse 96, BP
Does anyone still use age more than 55 as criteria for operative
management? What about routine angio-embolization of grade V injuries?
What would be your management? What wou