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Splenic injury from blunt abdominal trauma in children: follow-up evaluation with CT
E C Benya1, D I Bulas, M R Eichelberger
1Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC, USA.
Insights
The initial computed tomography (CT) grade of splenic injury in children predicts healing rates. Lower-grade injuries heal faster, while higher-grade injuries require longer healing times.
Area of Science:
- Pediatric Radiology
- Abdominal Imaging
- Trauma Imaging
Background:
- Splenic injuries are common in pediatric trauma.
- Accurate assessment of splenic injury severity is crucial for management.
- Computed tomography (CT) is the primary imaging modality for evaluating splenic trauma in children.
Purpose of the Study:
- To determine if the initial computed tomography (CT) grade of splenic injury in children correlates with the rate of healing.
- To establish a relationship between CT-defined injury severity and clinical outcomes.
Main Methods:
- Prospective follow-up of 37 children with splenic injuries.
- Initial grading of splenic injury using emergent CT.
- Follow-up CT scans (non-enhanced and contrast-enhanced) performed between 2 weeks and 11 months post-injury.
Main Results:
- All 15 grade 1 and 2 splenic injuries healed, with most showing healing within 4 months.
- 10 of 11 grade 3 injuries healed within 6 months.
- All 11 grade 4 injuries showed residual lesions within 4 months, with complete healing taking up to 11 months. Contrast-enhanced CT improved visualization of residual lesions.
- No splenic complications were observed.
Conclusions:
- The CT grade of splenic injury is a reliable predictor of healing rate in children.
- Grade 1 and 2 injuries typically heal within 4 months.
- Grade 3 and 4 splenic injuries demonstrate progressively longer healing times, up to 6 and 11 months, respectively.
Purpose:
To assess if the initial grade of splenic injury depicted at computed tomography (CT) in children could help predict rate of healing.
Materials And Methods:
Thirty-seven children with splenic injury graded at emergent CT were prospectively followed up with non-enhanced and contrast material-enhanced CT performed 2 weeks to 11 months after injury.
Results:
In all 15 grade 1 and 2 splenic injuries, healing was seen at follow-up, including eight injuries that occurred in patients who underwent follow-up CT within 4 months. In 10 of 11 grade 3 splenic injuries, healing was seen within 6 months. In all 11 grade 4 injuries, residual lesions were seen within 4 months and healing took up to 11 months. Five of nine residual splenic injuries were more clearly visualized with contrast material enhancement. No splenic complications occurred.
Conclusion:
CT grade of splenic injury is related to rate of healing. Grade 1 and 2 injuries typically heal within 4 months, whereas grade 3 injuries take up to 6 months to heal and grade 4 injuries take up to 11 months.