Efficacy of nonoperative management of blunt splenic injury in children

ABSTRACT

Background: Nonoperative treatment of blunt splenic injury in children has become routine standardization in Viet Nam. Objectives:This study aims to study the efficacy of nonoperative management (NOM) for blunt splenic injury (BSI) in children. Subjects and method: The records of all the patients treated in National Hospital of Pediatrics with final diagnosis blunt splenic injury between January 2000 and December 2006 were reviewed. The clinical signs, investigations, imaging studies, methods of treatment and results were analyzed. The splenic injuries were graded according to the American Association for the Surgery of Trauma (AAST). Results:There were 15 patients from one day to 12 years of age, with average injury grade 2.2. From 13 patients who were attempted NOM, only 2 patients (blunt liver injury - BLI grade 3 and 4) were operated thereafter because of continuing bleeding or worsening clinically, the remains of 12 recovered well with average hospitalized duration wasf 6 days. The NOM for BLI was successful in 11/13 (84.6%) in our series. Conclusion:NOM was highly efficient method and should be the standard initial approach for all the children with BLI. These patients must be closely monitored for prompt surgical treatment in case of NOM failure.