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Blunt splenic trauma in children

K Lakhoo1, D H Bass, S Cywes

  • 1Department of Paediatric Surgery, University of Cape Town.

Insights

Motor vehicle accidents are the leading cause of splenic trauma, often involving multiple injuries. Non-operative management is effective in children, while splenic salvage is achievable in surgical cases.

Area of Science:

  • Trauma surgery
  • Pediatric surgery
  • Emergency medicine

Background:

  • Splenic trauma is a significant concern, particularly following motor vehicle accidents.
  • Pedestrian injuries frequently result in severe abdominal trauma, including splenic injuries.
  • Multisystem trauma is common in patients with splenic injuries.

Purpose of the Study:

  • To review outcomes of splenic trauma management over an 11-year period.
  • To evaluate the efficacy of non-operative and operative management strategies.
  • To assess the feasibility of splenic salvage in surgical cases.

Main Methods:

  • Retrospective review of 96 patients with splenic trauma.
  • Confirmation of splenic injury via isotope scanning and laparotomy.
  • Analysis of management strategies (non-operative vs. operative) and outcomes.

Main Results:

  • 80% of injuries resulted from motor vehicle accidents (pedestrian).
  • Over 80% of patients had multiple injuries.
  • Non-operative management was successful in 87.5% of children with no complications.
  • Splenic salvage was achieved in 75% of patients requiring surgery.

Conclusions:

  • Non-operative management is a safe and effective approach for pediatric splenic trauma.
  • Surgical intervention allows for successful splenic salvage in a majority of cases.
  • Early diagnosis and appropriate management are crucial for favorable outcomes in splenic trauma.

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