The spleen after blunt injuries in children: a salvageable organ with conservative treatment

Document Type : Original Article

Authors

1 pediatric surgery department, sohag faculty of medicine

2 pediatric surgery department, sohag faculy of medicine

3 surgery

Abstract

Background During last decades, management of patients with Blunt Splenic Trauma shifted towards Non-Operative Management. As spleen is an important part of our immune system, spleen should be salvaged. Patients and methods This is a single center retrospective study, including (59 patients). monitoring of clinical and laboratory parameters was done in the intensive care unit (ICU). Grading of splenic injury based on CT with IV contrast finding. Results 59 patients were included with a mean age of 5±2.5 SD years. 35 males and 24females. All patients managed non-operatively. Falling from height was most common cause of trauma (52.5%). The most common associated injury was lower rib fracture with hemothorax in (18.6%). AAST grade I was noted in (27.1%), grade II in (50.8%), (11.9%) Patients received blood transfusion during the study period by 1 mg\kg of backed RBCs once for each patient. The mean length of hospital stay was 4.7 ± 2.5 SD days. No major complications were observed during the study period and no mortality among cases. Conclusion This single institution's experience over one-year reports no deaths and no splenectomies. Splenectomy has become very unusual in hemodynamically stable children with a splenic injury. The use of clinical practice guidelines has assisted with the management of this condition, especially in making the care more efficient, so we think that spleen is a salvageable organ in cases of pediatric splenic trauma and we recommend a larger study including more patients for better results.

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Sohag Medical Journal
Volume 29, Issue 2
Clinical Science Volume
2025
Pages 150-160

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