BackgroundChanging methods of evaluating blunt abdominal trauma and expanding selection criteria for nonoperative management (NOM) of splenic injury can increase the number of patients managed nonoperatively without affecting success rates.MethodsThe charts of 164 patients with blunt splenic injuries from July 1, 1991, to June 30, 1996, were reviewed. Thirty-eight patients were excluded because of immediate laparotomy without adjunctive tests or expiration in the resuscitative period. Injuries were graded according to the Organ Injury Scale.Results55 years old and in 14 of 15 patients with Glasgow Coma Scale scores < 13.Conclusion55 years or abnormal neurologic status should not preclude NOM, because success was related only to injury grade.