Changes in splenic capsule with aging; beliefs and reality

Research describing the splenic capsule and its effect on non-operative management of splenic injuries is limited. The aim of this study is to identify the current beliefs about the splenic capsule thickness and investigate changes in the splenic capsule with age. Trauma Medical Directors were surveyed on their beliefs regarding splenic capsule thickness changes with age. Thicknesses of cadaveric splenic capsule samples were measured. The majority of trauma medical directors (59%) believe the capsule thickness decreases with age. There were 94 splenic specimens obtained. The splenic capsules of infants were thin and had a uniform layer of elastin fibers. With aging, the capsule becomes thick and develops a collagen layer. Most trauma directors believe the splenic capsule thickness decreases with age. However, our results demonstrate that the splenic capsule thickness increases during childhood but remains constant in adulthood. •59% of surveyed surgeons believe splenic capsule thickness decreases with age.•Histological assessment of cadaveric spleens was performed.•Two capsule layers develop with age, an inner elastin and outer collagen layer.•Capsule thickness increases until age 20, then remains constant. The majority of surveyed Trauma Medical Directors believe that splenic capsule thickness decreases with age. Histological assessment demonstrated that with aging, the splenic capsule develops an inner elastin layer and outer collagen layer. Collagen and total thickness increase until age 20, then remains constant. Elastin thickness increases until age 10.