Long-term outcome of nonoperative pediatric splenic injury management

J Pediatr Surg. 2007 Jun;42(6):1038-41; discussion 1041-2. doi: 10.1016/j.jpedsurg.2007.01.039.

Abstract

Background: Nonoperative management (NOM) of blunt splenic trauma is the standard of care in hemodynamically stable children. The long-term risk of this strategy remains unknown. The object of this study was to investigate the incidence of long-term complications after NOM of pediatric splenic injury.

Methods: All children who underwent NOM for blunt splenic trauma over an 11-year period were identified. Patients were interviewed for any ailments that could be related to their splenic injury, and hospital data were analyzed.

Results: A total of 266 patients were identified, and 228 patients (86%) were interviewed. Mean follow-up time was 5 +/- 3 years. One patient had a delayed complication, a splenic pseudocyst. Pain more than 4 weeks after injury was unusual. Time until return to full activity varied broadly.

Conclusion: The incidence of long-term complications after NOM of pediatric splenic injury was 1 (0.44%) in 228 patients. Nonoperative management of pediatric blunt splenic trauma in children is associated with a minimal risk of long-term complications.

MeSH terms

  • Abdominal Pain / etiology
  • Accidental Falls
  • Accidents, Traffic
  • Adolescent
  • Adult
  • Bicycling / injuries
  • Boston / epidemiology
  • Child
  • Child, Preschool
  • Cysts / etiology
  • Disease Management
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Registries
  • Retrospective Studies
  • Risk
  • Spleen / injuries*
  • Splenic Diseases / etiology
  • Trauma Centers / statistics & numerical data
  • Trauma Severity Indices
  • Wounds, Nonpenetrating / therapy*