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The incidence of delayed splenic bleeding in pediatric blunt trauma

David M Notrica1, Lois W Sayrs1, Amina Bhatia2

  • 1Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ, USA 85016.

Journal of Pediatric Surgery
|October 29, 2017
PubMed

Insights

Delayed splenic bleeding (DSB) is a concern in pediatric blunt splenic injuries (BSI) managed nonoperatively. This multicenter study found no cases of DSB, suggesting a very low incidence in children.

Area of Science:

  • Pediatric Trauma Surgery
  • Abdominal Trauma Management
  • Splenic Injury Treatment

Background:

  • Nonoperative management of pediatric blunt splenic injuries (BSI) carries a risk of delayed splenic bleeding (DSB).
  • Previous studies indicated a low but present incidence of DSB.
  • Evaluating DSB incidence is crucial for optimizing pediatric BSI management.

Purpose of the Study:

  • To evaluate the incidence of delayed splenic bleeding (DSB) in children with blunt splenic injuries (BSI) managed nonoperatively.
  • To assess the safety and efficacy of nonoperative management strategies for pediatric BSI.
  • To provide updated data on DSB rates from a multicenter prospective study.

Main Methods:

  • A 3-year prospective study involving 10 pediatric trauma centers.
  • Inclusion of pediatric patients (≤18 years) with blunt splenic injuries (BSI).
  • Patient follow-up at 14 and 60 days to monitor for complications like DSB.

Main Results:

  • 508 children with BSI were included; median age 11.6 years, median injury grade 3.
  • Nonoperative management was successful in 92% of patients (466/508).
  • No cases of delayed splenic bleed (DSB) were observed during the study period.

Conclusions:

  • The incidence of delayed splenic bleeding (DSB) in pediatric blunt splenic injuries (BSI) managed nonoperatively appears to be very low, potentially less than 0.2%.
  • These findings support the continued use and safety of nonoperative management for pediatric BSI.
  • Further research may refine understanding of risk factors and optimal follow-up protocols.
Abstract

Keywords:
Abdominal traumaBlunt traumaDelayed bleedInjuryPediatricSplenic injury

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