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June 1982

Changing Treatment of Pediatrie Splenic Trauma

Author Affiliations

From the Department of Surgery, Good Samaritan Hospital, Cincinnati (Dr Kakkasseril); Department of Urology, University of Cincinnati Medical Center (Dr Stewart); Departments of Pediatrie Surgery (Dr Cox) and Nuclear Medicine (Dr Gelfand), Children's Hospital Medical Center, Cincinnati.

Arch Surg. 1982;117(6):758-759. doi:10.1001/archsurg.1982.01380300006002

• A review of splenic injuries at Cincinnati Children's Hospital Medical Center from July 1978 to June 1980 revealed this form of injury in 29 patients. Treatment without surgery was successful in 21 patients. Seven patients required operation. One patient died shortly after admission of severe associated injuries. All patients admitted with blunt abdominal trauma were initially treated conservatively. If the clinical state improved, after transfusions if necessary, or remained stable and there were no objective signs of further blood loss, conservative therapy was continued. Liver-spleen scans were obtained on an urgent basis to confirm the diagnosis of splenic injury in patients who did not undergo surgery. No complications of treatment without surgery were recognized. The satisfactory outcome in these patients suggests that there is a place for treatment without surgery in some children with splenic injury.

(Arch Surg 1982;117:758-759)