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Pleural effusion following blunt splenic injury in the pediatric trauma population

Afif N Kulaylat1, Brett W Engbrecht2, Carolina Pinzon-Guzman3

  • 1Division of Pediatric Surgery, Penn State Hershey Children's Hospital, Hershey, PA, USA; Department of Public Health Sciences, Penn State Hershey Medical Center, Hershey, PA, USA.

Journal of Pediatric Surgery
|August 24, 2014
PubMed

Insights

Pleural effusion complicates pediatric blunt splenic injury in 4.4% of cases, particularly high-grade injuries. Many children require interventions, leading to longer hospital stays.

Area of Science:

  • Pediatric Trauma Surgery
  • Thoracic Complications
  • Splenic Injury Management

Background:

  • Pleural effusion is a known complication of blunt splenic injury.
  • Limited data exists on its incidence, risk factors, and management in children.

Purpose of the Study:

  • To determine the incidence of pleural effusion after pediatric blunt splenic injury.
  • To identify risk factors and describe clinical management strategies.

Main Methods:

  • Retrospective review of a pediatric trauma registry from 2000-2010.
  • Analysis of 318 children with blunt splenic injury, focusing on 274 nonoperatively managed cases.

Main Results:

  • 12 patients (4.4%) developed left-sided pleural effusions.
  • High-grade splenic injury (IV-V) was associated with increased odds of effusion (OR 16.5).
  • Patients with effusions had longer lengths of stay; 58% required tube thoracostomy.

Conclusions:

  • Pleural effusion occurs in 4.4% of pediatric blunt splenic injuries, linked to high-grade injuries.
  • Management varies, with many requiring tube thoracostomy for respiratory compromise.
  • Effusions significantly increase hospital length of stay.
Abstract

Keywords:
Blunt splenic injuryNonoperative managementPediatric traumaPleural effusionSplenic laceration

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