Related Experiment Video
Updated: Aug 9, 2026
International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Pleuro-pulmonary involvement in children with blunt splenic trauma
A Gorenstein1, M Witzling, L T Haftel
1Department of Paediatric Surgery, Edith Wolfson Medical Center, PO Box 5, Holon 58100, Israel.
Insights
Nearly half of pediatric blunt splenic trauma cases involve pleuro-pulmonary complications, either immediately or delayed. Early detection through monitoring temperature and chest X-rays is crucial for managing these injuries.
Area of Science:
- Pediatric Traumatology
- Thoracic Surgery
- Emergency Medicine
Background:
- Blunt splenic trauma is a significant concern in pediatric patients.
- Pleuro-pulmonary involvement can complicate splenic injuries, impacting patient outcomes.
- Understanding the incidence and timing of pleuro-pulmonary complications is essential for effective management.
Purpose of the Study:
- To evaluate the significance of pleuro-pulmonary involvement in children with blunt splenic trauma.
- To determine the frequency and presentation of pleuro-pulmonary complications in this cohort.
- To highlight the importance of early diagnosis and management of these associated injuries.
Main Methods:
- Retrospective chart review of 27 pediatric patients (aged 2-16 years) treated for blunt splenic injury between 1992 and 1999.
- Analysis of patient data including splenic injury grade, presence of pleuro-pulmonary involvement, and clinical presentation.
- Correlation of pleuro-pulmonary involvement with injury severity and patient outcomes.
Main Results:
- Pleuro-pulmonary involvement was diagnosed in 44.4% of patients, occurring either as primary injury or delayed complication.
- Patients with pleuro-pulmonary involvement exhibited more severe splenic injuries compared to those without.
- Key signs included chest pain, dyspnea, diminished breath sounds, and elevated body temperature; delayed complications were noted in some cases.
Conclusions:
- Pleuro-pulmonary involvement is a frequent occurrence in pediatric blunt splenic trauma, observed in nearly half of cases.
- Complications can manifest early due to direct chest trauma or present later.
- Prompt recognition, vigilant temperature monitoring, and serial chest X-rays are vital for timely diagnosis and treatment of delayed pleuro-pulmonary issues.
Objective:
Evaluation of the importance of pleuro-pulmonary involvement in paediatric patients with blunt splenic trauma.
Method:
A retrospective chart review of 27 patients, aged 2-16 years, treated for blunt splenic injury between 1992 and 1999 was performed.
Results:
All patients except one were treated conservatively. In 12 patients (44.4%) left-sided pleuro-pulmonary involvement was diagnosed as primary traumatic injury or as a late complication. While Grade I and II splenic injuries were prevalent, pleuro-pulmonary involvement patients had a more severe degree of splenic injury. Chest pain, dyspnoea and diminished respiratory sounds were present on primary examination in patients with chest trauma. Body temperature during the first 5 post-trauma days was significantly higher among pleuro-pulmonary involvement patients. Specific pleuro-pulmonary involvement diagnoses on admission in six children with primary chest trauma were: lung contusion, pleural thickness, or haemo-pneumothorax. Three of them developed delayed pleural effusion. In the other six children with pleuro-pulmonary involvement, late complications appeared during 2-5 days post-trauma.
Conclusions:
Pleuro-pulmonary involvement was observed in almost half of patients with blunt splenic trauma. Pleuro-pulmonary involvement occurred either early as a result of direct chest trauma or was delayed. High suspicion, careful monitoring of body temperature and repeated chest X-ray studies are recommended for early diagnosis and treatment of delayed pleuro-pulmonary involvement.
Related Concept Videos
01:13Pleura of the Lungs
01:24Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:27Pneumothorax-II
Clinical Manifestations:
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:08Pneumothorax II: Pathophysiology