[Experience with non-surgical treatment of splenic injuries]

Since 1980 in the department of paediatric surgery in Prague-Krc injury of the spleen is no longer an absolute indication for laparotomy and splenectomy. During the period from 1980-1990 46 children were admitted with an injured spleen. Of these 35 (76%) were treated conservatively, 11 children were operated. The number of conservatively treated patients increased in the course of time--during the initial period before 1985 65% children were treated conservatively, from 1986 to 1990 already 90% children. Only 16% children with an injured spleen treated conservatively needed a blood transfusion (on average 18.1 ml/kg body weight). This experience indicates that the great majority of children with an injured spleen can be treated by non-surgical methods. It is necessary to respect certain criteria which are given in the paper. Laparotomy is necessary in children with unstable vital functions, associated intraabdominal injuries and those to whom more than 30 ml blood per kg body weight must be administered.