Objectives: To review the management of Splenic trauma (operative vs conservative management) and our outcomes. Type of Study: Retrospective observational study. Period of Study: 2000-2015. Methodology: There have been 36 cases who were admitted with splenic trauma in our institution over the last 15 yrs. ICD-10 Code S36.0 was used to identify these patients. A thorough review of their files was undertaken. Results: AAST Grading for splenic injury was done for these cases and there were 3 cases of grade 1, 6 cases of grade 2, 13 cases of grade 3, 12 cases of grade 4 and 2 cases of grade 5. Of these, both cases of Grade 5 injury were operated immediately, while 4 out of 12 cases of grade 4 injury were operated immediately. Of the 8 cases of grade 4 injury which were managed conservatively, One case needed to be operated at a later date, which is our only case of failure of conservative management. Usion criteria. One case of grade 3 injury was operated, while all cases of grade 1 and 2 were managed conservatively. We had 7 cases of Operative management (OM), 28 cases of Successful conservative management (CM) and 1 case of Failure of conservative management (FOC). Conclusion: The goal of this study was to evaluate the success of the various strategies (conservative vs surgical) and their outcome. Our study shows that conservative management has a major role to play in hemodynamically stable patients even if their AAST grading of Splenic injury was 4. But these patients who are managed conservatively, need to be monitored closely and the surgeon should be ready to take the patient up for emergency surgery if any signs of worsening are evident. The failure of non-operative management can be life-threatening and even fatal if the deterioration is not picked up immediately.

Keywords: Splenic Trauma; Splenic Injury; Conservative Management; Non-Operative Management; Splenectomy; AAST Grading.