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Multimodality management in severe pediatric spleen trauma.

M Iuchtman¹, R Alfici, E Sternberg

¹Department of Surgery A, Hillel Yaffe Medical Center, Hadera and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. http:/hy.health.gov.il

The Israel Medical Association Journal : IMAJ

|September 9, 2000

Summary

Pediatric spleen trauma management can preserve spleen tissue using mesh wrapping and autotransfusion. This multimodality approach ensures survival and spleen function in children with severe spleen rupture.

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Area of Science:

Pediatric Surgery
Trauma Management
Spleen Preservation

Background:

Trauma is a leading cause of death in children.
Abdominal injuries frequently involve the spleen.
Spleen tissue conservation has been a focus in recent decades.

Purpose of the Study:

To analyze a multimodality management policy for pediatric spleen injuries.
Evaluate the use of autotransfusion and mesh wrapping in spleen conservation.

Main Methods:

Retrospective analysis of 14 years of data (1985-1998).
Inclusion of 122 children treated for severe spleen rupture.
Application of techniques including absorbable mesh wrapping, partial splenectomy, and autotransfusion.

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Main Results:

Mesh wrapping was used in 16 children to achieve hemostasis and preserve spleen tissue.
All children survived with a functional spleen.
No cases of rebleeding were reported; one instance of postoperative fever was managed successfully.

Conclusions:

Mesh wrapping, partial splenectomy, and autotransfusion are effective in preserving severely injured spleens.
Autotransfusion is a simple technique valuable in resource-limited settings or mass casualty incidents.
This multimodality approach leads to successful outcomes in pediatric spleen trauma.