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Blunt splenic trauma in children: a retrospective study of non‐operative management
Author(s) -
COHEN R. C.
Publication year - 1982
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.1982.tb02032.x
Subject(s) - medicine , splenectomy , blunt , surgery , avulsion , retrospective cohort study , blunt trauma , sepsis , spleen
. This paper is a retrospective study of the management of 58 cases of blunt splenic injury in the paediatric age group. Fifty of these cases were managed at the Adelaide Children's Hospital during the period 1964–1980 and eight cases at the Flinders Medical Centre during the period 1976–1980. A policy of non‐operative management of blunt splenic injury was introduced to the Adelaide Children's Hospital in 1964, a policy not fully adopted until 1975. By this time nuclear scanning techniques were readily available and enabled accurate diagnosis of splenic trauma. Follow‐up scans provided more knowledge of the healing process. Between 1975 and 1980 a total of 42 proven cases of blunt splenic injury were treated non‐operatively, including one case of total avulsion of the spleen. Splenectomy was performed on 16 cases, all prior to June 1975. There was no case of post‐splenectomy sepsis. Post‐operative obstruction due to small bowel adhesions was encountered in 25% of the splenectomy cases. Comparison of results shows that non‐operative management is preferable in selected children when adequate monitoring facilities are available. If the clinical condition deteriorates, operative intervention is indicated; this occurred in two patients, both of whom underwent splenectomy. Of the 42 patients treated non‐operatively, delayed haemorrhage occurred in only one. There was no evidence of a post‐traumatic splenic cyst in any of the follow‐up scans.