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ANZ J Surg. 2011 Oct;81(10):717-9.

Factors predicting the need for splenectomy in children with blunt splenic trauma.

Author information

1
Department of Paediatric Surgery, John Hunter Children's Hospital, University of Newcastle, Newcastle, New South Wales, Australia.

Abstract

BACKGROUND/PURPOSE:

Non-operative management of blunt splenic trauma (BST) in children is the standard of care with a success rate of greater than 90%. This paper aims to determine the factors which could predict the need for operative intervention in children with BST.

METHODS:

Prospectively entered data of 69 children with BST, between 1997 and 2008, from a single tertiary level trauma centre, were retrospectively analysed. A radiologist blinded to the outcome reviewed all computed tomography scans retrospectively.

RESULTS:

Forty-two children had isolated BST (61%) and 27 children had associated injuries (39%). All except one survived the injury and non-operative treatment was successful in 91%. Six of the 69 children (9%) with BST underwent splenectomy. There was no independent correlation to age, gender, mechanism of injury (MOI), injury grade and the need for splenectomy, whereas haemodynamic instability within 6 h of injury defined as failed resuscitation had a 100% correlation.

CONCLUSION:

Haemodynamic instability, which failed to respond to resuscitation within 6 h, predicted the need for splenectomy in children with BST. Splenic injury grade assessed by computed tomography scan does not predict the need for splenectomy.

PMID:
22295313
[Indexed for MEDLINE]

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