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Blunt splenic injury in Sikkimese children and adolescents

Pradip Kumar Mohanta1, Amrita Ghosh, Ranabir Pal

  • 1Department of Surgery, Calcutta National Medical College, Kolkata, India.

Journal of Emergencies, Trauma, and Shock
|July 20, 2011
PubMed

Insights

Pediatric splenic injuries are increasingly managed nonoperatively. This study found that while many children with blunt splenic trauma undergo splenectomy, nonoperative management (NOM) and salvage operations are also effective, with 33 cases successfully managed with NOM.

Area of Science:

  • Pediatric Surgery
  • Trauma Management
  • Abdominal Injuries

Background:

  • Nonoperative management (NOM) and salvage operations are increasingly considered for pediatric splenic injuries.
  • Blunt splenic trauma requires careful evaluation of risk factors, presentation, severity, and intervention outcomes.

Purpose of the Study:

  • To identify risk factors, clinical presentations, injury severities, and intervention outcomes for blunt splenic injuries in children and adolescents.
  • To evaluate the effectiveness of operative versus nonoperative management strategies for pediatric splenic trauma.

Main Methods:

  • Retrospective review of pediatric patients with splenic injury admitted between January 2005 and December 2009.
  • Splenic injuries graded using the American Association for the Surgery of Trauma (AAST) Splenic Injury Scale.
  • Analysis of operative and nonoperative management (NOM) outcomes.

Main Results:

  • 147 cases of splenic injury were identified, predominantly in males and adolescents over 16 years old.
  • Falls from height and road traffic accidents were the primary causes of injury.
  • 87 patients required immediate surgery; NOM failed in 27 cases, leading to splenectomy (8) or salvage (19). 33 cases were successfully managed with NOM.

Conclusions:

  • A significant proportion of pediatric splenic injuries (64.63%) were managed with splenectomy.
  • Salvage operations were performed in 19 cases initially managed nonoperatively.
  • Nonoperative management (NOM) proved successful in 33 pediatric splenic injury cases, highlighting its viability.
Abstract

Keywords:
Splenectomynonoperative managementsplenic injury

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