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Eur J Pediatr. 2013 Sep;172(9):1187-90. doi: 10.1007/s00431-013-2022-7. Epub 2013 May 5.

Comparison of two treatment eras and sonographic long-term outcome of blunt splenic injuries in children.

Author information

1
Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria. georg.singer@medunigraz.at

Abstract

The treatment of blunt splenic injuries (BSI) has undergone a significant shift away from an operative approach to a conservative treatment regimen in the last decades. Data concerning long-term follow-up of children sustaining BSI are largely confined to telephone surveys. Children treated with BSI over a 33-year period were analyzed. In order to describe the changing treatment, patients were divided into two groups: group I included children treated between 1977 and 1999; group II children treated between 2000 and 2009. Additionally, patients treated nonoperatively between 2000 and 2009 were invited for a sonographic follow-up examination. In group I 81 patients and in group II 89 patients were treated. An increase of male patients from 69 to 88 % was observed, comparing the two eras. While children treated in the earlier period were 8.8-years-old mean (range 1 to 15), the patients treated between 2000 and 2009 were older (mean 10.4 years, range 1 to 17). Between 1977 and 1999, 79 % of the patients were treated nonoperatively. This rate considerably increased to 94 % in the second era. Follow-up examination was performed with a mean age of 6 years (range 1 to 11 years) post-injury. In 79 % of the cases, the spleen healed without sonographic long-term sequelae. In the remaining 21 % of the patients, a scar formation could be demonstrated.

CONCLUSION:

We were able to confirm that the majority of children sustaining BSI can be safely treated conservatively.

PMID:
23644650
DOI:
10.1007/s00431-013-2022-7
[Indexed for MEDLINE]

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