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Splenic Rupture in Children With Portal Hypertension

Orith Waisbourd-Zinman1,2,3, Amit Shah1, Henry C Lin1,3

  • 1Children's Hospital of Philadelphia, Philadelphia, PA.

Journal of Pediatric Gastroenterology and Nutrition
|February 23, 2018
PubMed

Insights

Splenic rupture is rare in children with portal hypertension (PHTN) and massive splenomegaly, often resulting from falls rather than sports. Hepatologists recommend restricting high-impact sports and consider spleen guards for injury prevention.

Area of Science:

  • Pediatric Hepatology
  • Gastroenterology
  • Trauma Surgery

Background:

  • Massive splenomegaly in children with portal hypertension (PHTN) poses a risk of splenic rupture.
  • Limited data exists on the incidence, causes, and prevention strategies for splenic rupture in this population.

Purpose of the Study:

  • To investigate cases of splenic rupture in pediatric patients with PHTN.
  • To describe current practices among hepatologists for preventing splenic rupture.

Main Methods:

  • An international survey was distributed to pediatric hepatologists in academic centers.
  • The survey collected data on splenic rupture cases and prevention strategies.

Main Results:

  • Thirteen cases of splenic rupture were reported, with 11 linked to trauma (mostly falls).
  • Hepatologists generally agreed on restricting high-risk sports but varied on spleen guard recommendations.
  • Platelet count was not considered a factor in decision-making by most practitioners.

Conclusions:

  • Splenic rupture appears rare in children with PHTN-induced splenomegaly.
  • Recommendations include restricting high-impact sports and considering spleen guards for activities with fall or trauma risk.
Abstract

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