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Selective splenic artery embolization or use of polyglycolic acid mesh in children with severe splenic trauma
J Uroz Tristan1, D Poenaru, F Martinez Lagares
1Pediatric Surgery Service, Hospital Materno Infantil Las Palmas de Gran Canaria, Spain.
Insights
Pediatric splenic trauma is rarely surgical. For severe injuries, splenic preservation is key. Selective arterial embolization offers a minimally invasive approach with good outcomes and low costs.
Area of Science:
- Pediatric Surgery
- Trauma Management
- Interventional Radiology
Background:
- Splenic trauma in children is typically managed non-operatively.
- Surgical intervention for pediatric splenic injuries is uncommon.
- Splenic preservation is a primary goal when operative management is necessary.
Purpose of the Study:
- To present the experience with managing severe splenic injuries in children over one year.
- To evaluate the efficacy and outcomes of different splenic preservation techniques.
- To highlight the advantages of percutaneous selective splenic artery embolization.
Main Methods:
- Review of 5 cases of severe splenic injuries in children.
- Surgical management using resorbable mesh in three patients.
- Percutaneous selective splenic artery embolization under fluoroscopic guidance in two patients.
Main Results:
- Successful splenic preservation was achieved in all 5 patients.
- Embolization group showed good outcomes with low morbidity.
- Embolization technique demonstrated low economic and social costs.
Conclusions:
- Percutaneous selective splenic artery embolization is an effective and advantageous technique for managing severe pediatric splenic injuries.
- Minimally invasive approaches like embolization should be considered for splenic preservation in pediatric trauma.
- Conservative and interventional radiology techniques minimize the need for splenectomy in pediatric splenic trauma.
Abstract:
Children with splenic trauma are managed conservatively in most circumstances, and the need for surgical intervention is very rare. When surgical exploration in mandatory, splenic preservation is a worthwhile objective, using various suture methods, biomaterials, or resorbable prostheses. We present our experience over the past year with 5 severe splenic injuries. Three of these patients were treated operatively with a resorbable mesh, while the other two were managed percutaneously by selective embolization of the splenic artery under fluoroscopic control. We describe the embolization technique with its advantages, good outcome with low morbidity, and low economic and social cost.