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Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions
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Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions

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[Complications in the conservative managemennt of splenic rupture]

P Rodríguez Iglesias1, L Rodríguez Caraballo1, M Couselo Jerez1

  • 1Servicio de Cirugía Pediátrica. Hospital Universitari i Politècnic la Fe. Valencia.

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
|December 22, 2017
PubMed

Insights

Conservative management of splenic rupture in children can lead to complications. Ultrasound monitoring is valuable for detecting early issues, with most complications resolving spontaneously or via embolization, avoiding surgery.

Area of Science:

  • Pediatric Surgery
  • Trauma Management

Background:

  • Non-surgical treatment is standard for hemodynamically stable children with splenic rupture.
  • Complications can arise during the follow-up period of conservative splenic rupture management.

Purpose of the Study:

  • To investigate the frequency, progression, and treatment of complications following conservative splenic rupture management in children.
  • To assess the efficacy of the American Pediatric Surgical Association (APSA) clinical guidelines for conservative splenic rupture treatment.

Main Methods:

  • Retrospective analysis of pediatric patients (under 15) with blunt abdominal trauma and splenic injury (2010-2016).
  • Evaluation of demographic data, injury mechanisms, and American Association for the Surgery of Trauma (AAST) injury grades.
  • Analysis of complication onset, characteristics, and treatment, including embolization for specific cases.

Main Results:

  • Twenty-eight children were included; 25% experienced complications, including arteriovenous fistulas, pseudo-aneurysms, and hemorrhages.
  • Complications were diagnosed at a median of 5.67 days post-injury.
  • Two pseudo-aneurysms were treated with embolization; one patient required splenectomy for rebleeding; other complications resolved spontaneously.

Conclusions:

  • Ultrasound monitoring aids in the early detection of splenic rupture complications in children.
  • Most complications from conservative splenic rupture management can be managed non-surgically.
Abstract

Keywords:
Blunt abdominal traumaEmbolizationHemodynamic stabilityNon-operative managementSpleen injury

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