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[The risk of death from splenic ruptures by polytrauma among children]

V V Podkamenev, I A Pikalo, A P Zaĭtsev

    Khirurgiia
    |April 25, 2013
    PubMed

    Insights

    Pediatric splenic injuries are common in polytrauma, but rarely cause immediate death. Intrathoracic bleeding from spleen rupture poses a significantly higher mortality risk than intraabdominal bleeding.

    Area of Science:

    • Pediatric Surgery
    • Trauma Surgery
    • Emergency Medicine

    Background:

    • Polytrauma in children presents complex challenges, with intra-abdominal injuries being a significant concern.
    • Splenic injuries are frequently observed in pediatric polytrauma cases, necessitating a thorough understanding of their impact.

    Purpose of the Study:

    • To analyze the incidence, characteristics, and outcomes of splenic injuries in children with lethal polytrauma.
    • To compare the risks associated with intra-abdominal versus intrathoracic bleeding from splenic rupture.

    Main Methods:

    • Retrospective analysis of 105 children with polytrauma and lethal outcomes.
    • Evaluation of injury patterns, bleeding volumes (hemoperitoneum and hemothorax), and mortality risks.

    Main Results:

    • Splenic injury occurred in 31.4% of pediatric polytrauma cases, twice as often as liver injury.
    • Intrathoracic bleeding from spleen rupture (977±866.9 ml) was significantly greater than hemoperitoneum (311±270.3 ml).
    • The risk of death from intrathoracic bleeding due to spleen rupture was 45 times higher than from intra-abdominal bleeding.

    Conclusions:

    • While splenic injuries are common in pediatric polytrauma, they are associated with a low risk of immediate death.
    • The primary causes of death in pediatric polytrauma remain brain injury, thoracic cavity injuries leading to hemorrhagic shock, and traumatic shock.

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