Over the last few decades, there has been a considerable shift toward a more conservative approach in the management of splenic trauma, with an emphasis on the preservation of splenic function and, currently, Nonoperative Management (NOM) has become the standard management technique in hemodynamically stable patients with spleen injuries. In western countries, 90–85% of traumatic splenic injury patients receive NOM, while the remainder has an immediate splenectomy for hemorrhagic shock or hemodynamic instability. Current data suggest NOM has a success rate of up to 95%, and the effectiveness of conservative treatment decreases as the AAST grade increases: NOM failure rate is reported to be 2–10% for AAST Grades I–II, 10–20% for AAST Grade III, 40–43% for AAST Grade IV, and up to 70–75 for AAST Grade V injuries.

The treatment of blunt splenic injuries showed major evolutionary changes, from fundamental/ basic splenectomy to nonoperative and endovascular treatment, "catheter surgery". Currently, in Trauma Centers, splenic angioembolization is considered the first-line intervention in trauma. Patients with contrast extravasation or pseudoaneurysm on CT scan, who are hemodynamically stable enough to make it to the interventional suite and have no other indication for laparotomy, may be considered for splenic angioembolization (5,6).