Laparoscopic examination of the traumatized spleen with blood salvage for autotransfusion.

The management of splenic trauma presents a dilemma to the surgeon, who must weigh the risks of operative versus nonoperative management. Laparoscopy has been used increasingly for trauma cases to decrease the morbidity associated with standard laparotomy. Autotransfusion of the patient's shed blood has also become widespread to decrease the risks associated with transfusion. We describe the case of a 15-year-old male with blunt splenic trauma, in which laparoscopy was used to examine the spleen to ascertain the need for operative treatment, to look for other intra-abdominal injuries, and to salvage intraperitoneal blood for autotransfusion. In this case, laparoscopy determined that laparotomy would be nontherapeutic, and that autotransfusion could obviate the need for banked-blood transfusion.