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Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review
Published on: March 27, 2026
Pediatric blunt splenic trauma: a comprehensive review
Karen N Lynn1, Gabriel M Werder, Rachel M Callaghan
1Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, MI 48073-6769, USA.
Insights
Pediatric splenic trauma requires careful management, prioritizing nonoperative approaches and splenic salvage to avoid splenectomy. Hemodynamic stability, not just imaging, guides treatment decisions in children.
Area of Science:
- Pediatric Surgery
- Trauma Management
- Diagnostic Imaging
Background:
- Abdominal trauma is a significant cause of mortality in children.
- The spleen is the most frequently injured organ in pediatric blunt abdominal trauma.
- Pediatric trauma patients present distinct challenges compared to adults.
Purpose of the Study:
- To review the mechanism of injury, imaging, management, and complications of traumatic splenic injury in pediatric patients.
- To emphasize the American Association for the Surgery of Trauma organ injury grading system.
- To compare existing clinical practice guidelines with institutional experience.
Main Methods:
- Comprehensive literature review.
- Presentation of multiple pediatric patient cases.
- Discussion of clinical practice guidelines and institutional experience.
Main Results:
- Nonoperative management and splenic salvage are preferred over splenectomy to reduce risks and improve outcomes.
- Hemodynamic stability is the primary determinant for management in pediatric patients.
- Imaging plays a crucial role in determining the level and duration of care post-diagnosis.
Conclusions:
- Early and accurate detection of splenic injury is critical.
- Nonoperative strategies and splenic preservation are vital in pediatric splenic trauma.
- Recommendations for future practice guidelines are proposed based on evidence and experience.
Abstract:
Abdominal trauma is a leading cause of death in children older than 1 year of age. The spleen is the most common organ injured following blunt abdominal trauma. Pediatric trauma patients present unique clinical challenges as compared to adults, including different mechanisms of injury, physiologic responses, and indications for operative versus nonoperative management. Splenic salvage techniques and nonoperative approaches are preferred to splenectomy in order to decrease perioperative risks, transfusion needs, duration/cost of hospitalization, and risk of overwhelming postsplenectomy infection. Early and accurate detection of splenic injury is critical in both adults and children; however, while imaging findings guide management in adults, hemodynamic stability is the primary determinant in pediatric patients. After initial diagnosis, the primary role of imaging in pediatric patients is to determine the level and duration of care. We present a comprehensive literature review regarding the mechanism of injury, imaging, management, and complications of traumatic splenic injury in pediatric patients. Multiple patients are presented with an emphasis on the American Association for the Surgery of Trauma organ injury grading system. Clinical practice guidelines from the American Pediatric Surgical Association are discussed and compared with our experience at a large community hospital, with recommendations for future practice guidelines.
