Penetrating Injuries to the Spleen and Kidney: an Evolution in Progress

Optimal management of penetrating abdominal trauma, especially for kidney and splenic injuries, is evolving. Opinions range from aggressive surgical exploration to expectant management. This report addresses the recent advancements in the diagnosis, grading, and management of penetrating injuries to the kidney and spleen. A special focus is provided on the shifting paradigm towards non-operative management. Penetrating renal trauma management has evolved significantly over the past few years. Advancements in diagnostic tools and evolution of injury grading have paved the way for selective non-operative management. Penetrating injuries to the spleen provide a unique management challenge. With the evolution of non-operative management, appropriate patient selection is mandatory. Optimal use of computed tomography scanning and angiography can improve the organ salvage rates; however, hemorrhage control is still the main goal.