A retrospective study of 56 children managed by splenectomy for traumatic splenic rupture is reported. The nature of abdominal injury often seemed trivial, and major associated injuries occurred only in eight children struck by an automobile. Shoulder pain and an elevated white blood cell count were frequent findings in addition to abdominal pain and tenderness. Immediate diagnosis was made in 68% of cases. In the remaining 32% the diagnosis was initially uncertain. A falling hematocrit on repeated determinations was the single most important factor in achieving the diagnosis in this group. Clinical manifestations of profound hypovolemia were uncommon and did not develop in those children in whom splenectomy was delayed. There was no mortality in this series and delay in treatment was not hazardous.
Miller DW, Kelley DL. Splenic TraumaSurgical Management in Children. Arch Surg. 1972;105(4):561-563. doi:10.1001/archsurg.1972.04180100012005