Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Mar;68(3):522-5.
doi: 10.1097/TA.0b013e3181ce1ed5.

Long-term follow-up of children with nonoperative management of blunt splenic trauma

Hunter B Moore  1 , Dennis W Vane
Affiliations

Long-term follow-up of children with nonoperative management of blunt splenic trauma

Hunter B Moore et al. J Trauma. 2010 Mar.

Abstract

Background: : The effectiveness of nonoperative management (NOM) of blunt splenic injuries (BSIs) in children is established; however, only limited data of their long-term follow-up exist. We hypothesize that long-term follow-up verifies that NOM of BSI in children is safe and effective.

Methods: : From 1993 to 2008, 153 children (1-17 years, mean = 12) with BSI were admitted. Patients were contacted by telephone and answered a standardized questionnaire. Medical records were reviewed to validate injury grade, hospital stay, and complications.

Results: : Eighty patients (52%) participated; 18 were excluded (8 splenectomies, 2 splenorraphies, 3 comatose, 2 language barriers, and 3 with unavailable records). Mean follow-up of the remaining 62 patients was 74 months (range, 5-165 months). There were 9 grade I, 9 grade II, 22 grade III, 20 grade IV, and 2 grade V injuries. Mechanism of injury was motor vehicle crashes (14), falls (11), all terrain vehicle (ATV) crashes (10), snow recreation related (14), and other recreation (13). Two patients were readmitted for spleen complications (splenic cyst and hematoma), but neither required additional treatment. Seven patients reported potential spleen-related complications: six immunologic (asthma, rashes, and increased illness), two abdominal pain, and two psychiatric related to fear of reinjuring their spleen. Three children sustained a second BSI, and none required surgical intervention.

Conclusions: : Long-term follow-up indicates that our protocol for NOM of BSI in children is safe, including secondary injuries. However, this study indicates that children who sustain BSI may require more counseling than presently provided. With an intact spleen, fear of immunologic dysfunction is irrational and indicates a lack of understanding at discharge. In addition, more intensive investigation and interventions for families that may suffer from posttraumatic stress disorder or related disorders appears indicated.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

  • Follow-up strategies for patients with splenic trauma managed non-operatively: the 2022 World Society of Emergency Surgery consensus document.
    Podda M, De Simone B, Ceresoli M, Virdis F, Favi F, Wiik Larsen J, Coccolini F, Sartelli M, Pararas N, Beka SG, Bonavina L, Bova R, Pisanu A, Abu-Zidan F, Balogh Z, Chiara O, Wani I, Stahel P, Di Saverio S, Scalea T, Soreide K, Sakakushev B, Amico F, Martino C, Hecker A, de'Angelis N, Chirica M, Galante J, Kirkpatrick A, Pikoulis E, Kluger Y, Bensard D, Ansaloni L, Fraga G, Civil I, Tebala GD, Di Carlo I, Cui Y, Coimbra R, Agnoletti V, Sall I, Tan E, Picetti E, Litvin A, Damaskos D, Inaba K, Leung J, Maier R, Biffl W, Leppaniemi A, Moore E, Gurusamy K, Catena F. Podda M, et al. World J Emerg Surg. 2022 Oct 12;17(1):52. doi: 10.1186/s13017-022-00457-5. World J Emerg Surg. 2022. PMID: 36224617 Free PMC article. Review.
  • Splenic trauma: WSES classification and guidelines for adult and pediatric patients.
    Coccolini F, Montori G, Catena F, Kluger Y, Biffl W, Moore EE, Reva V, Bing C, Bala M, Fugazzola P, Bahouth H, Marzi I, Velmahos G, Ivatury R, Soreide K, Horer T, Ten Broek R, Pereira BM, Fraga GP, Inaba K, Kashuk J, Parry N, Masiakos PT, Mylonas KS, Kirkpatrick A, Abu-Zidan F, Gomes CA, Benatti SV, Naidoo N, Salvetti F, Maccatrozzo S, Agnoletti V, Gamberini E, Solaini L, Costanzo A, Celotti A, Tomasoni M, Khokha V, Arvieux C, Napolitano L, Handolin L, Pisano M, Magnone S, Spain DA, de Moya M, Davis KA, De Angelis N, Leppaniemi A, Ferrada P, Latifi R, Navarro DC, Otomo Y, Coimbra R, Maier RV, Moore F, Rizoli S, Sakakushev B, Galante JM, Chiara O, Cimbanassi S, Mefire AC, Weber D, Ceresoli M, Peitzman AB, Wehlie L, Sartelli M, Di Saverio S, Ansaloni L. Coccolini F, et al. World J Emerg Surg. 2017 Aug 18;12:40. doi: 10.1186/s13017-017-0151-4. eCollection 2017. World J Emerg Surg. 2017. PMID: 28828034 Free PMC article. Review.
  • Comparison of two treatment eras and sonographic long-term outcome of blunt splenic injuries in children.
    Singer G, Rieder S, Eberl R, Wegmann H, Hoellwarth ME. Singer G, et al. Eur J Pediatr. 2013 Sep;172(9):1187-90. doi: 10.1007/s00431-013-2022-7. Epub 2013 May 5. Eur J Pediatr. 2013. PMID: 23644650