Trauma is globally the leading cause of death among people under the age of 45. In the Netherlands, the predominant trauma mechanism is blunt trauma, occurring in approximately 90% of the patients. The most commonly injured organ after blunt trauma to the abdomen is the spleen. As the spleen is highly vascular, splenic injury can be potentially life threatening due to bleeding. Dominique Olthof explores the diagnostics and treatment strategies of trauma patients with blunt abdominal (mainly splenic) injury.