[Treatment of closed spleen injuries with intraabdominal bleeding in children]

Area of Science:

• Pediatric Surgery
• Trauma Management
• Minimally Invasive Procedures

Background:

• Closed spleen injuries are common in children.
• Conservative management is preferred when feasible.
• Assessing treatment efficacy is crucial for patient outcomes.

Purpose of the Study:

• To validate conservative treatment protocols for pediatric closed spleen injuries.
• To evaluate the role of laparoscopy in managing these injuries.
• To assess the long-term outcomes of non-operative and minimally invasive approaches.

Main Methods:

• Retrospective analysis of 78 pediatric patients with closed spleen injuries.
• Comparison between a conservative management group (36 patients) and a laparoscopic intervention group (42 patients).
• Evaluation of surgical intervention rates, including splenectomy, and long-term follow-up for complications.

Main Results:

• Laparoscopy successfully averted major surgery in 69% of patients.
• Splenectomy was performed in 28.6% of cases.
• Only one splenectomy was required in the conservatively treated group due to persistent bleeding.
• No long-term complications like adhesive obstruction or pseudoaneurysms were noted.

Conclusions:

• Conservative management, augmented by laparoscopy when necessary, is a safe and effective strategy for pediatric closed spleen injuries.
• Minimally invasive approaches like laparoscopy significantly reduce the need for splenectomy.
• Long-term follow-up confirms the absence of significant post-treatment sequelae.