Liechti R, Fourie L, Stickel M, et al. - Researchers examined the incidence and time to failure of non-operative management (NOM) as well as to assess the relevance of follow-up imaging in this largest cohort of blunt splenic injury (BSI) patients with first-line ultrasound follow-up in NOM. They retrospectively examined a total of 122 individuals with BSI who were admitted to the level I trauma center, including two associated hospitals, between January 1, 2010, and December 31, 2017. Routine radiological examinations, both ultrasound and CT scan, led to the identification of no new significant findings in 96.4% of the cases. They observed a significant association of failure of NOM with clinical deterioration and unplanned follow-up imaging. In this study population, liver cirrhosis and contrast extravasation on initial CT scan were identified to be significant risk factors for the failure of NOM. No significant association of higher age, ISS and AAST grade with failure of NOM was observed. The outcomes of this study suggest a limited therapeutic advantage of routine follow-up imaging; this was observed regardless of the modality. Evidence for radiological follow-up should be based on clinical findings. They recommend using a CT scan as a preferred imaging modality if indicated.