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Review
. 2024 May 30;11(6):667.
doi: 10.3390/children11060667.

Management of Pediatric Solid Organ Injuries

Bailey D Lyttle  1 , Regan F Williams  2 , Steven Stylianos  3
Affiliations
Review

Management of Pediatric Solid Organ Injuries

Bailey D Lyttle et al. Children (Basel). .

Abstract

Solid organ injury (SOI) is common in children who experience abdominal trauma, and the management of such injuries has evolved significantly over the past several decades. In 2000, the American Pediatric Surgical Association (APSA) published the first societal guidelines for the management of blunt spleen and/or liver injury (BLSI), advocating for optimized resource utilization while maintaining patient safety. Nonoperative management (NOM) has become the mainstay of treatment for SOI, and since the publication of the APSA guidelines, numerous groups have evaluated how invasive procedures, hospitalization, and activity restrictions may be safely minimized in children with SOI. Here, we review the current evidence-based management guidelines in place for the treatment of injuries to the spleen, liver, kidney, and pancreas in children, including initial evaluation, inpatient management, and long-term care, as well as gaps that exist in the current literature that may be targeted for further optimization of protocols for pediatric SOI.

Keywords: kidney; liver; pancreas; pediatric trauma; solid organ injury; spleen; surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
American Pediatric Surgical Association updated blunt liver/spleen guidelines. Updated American Pediatric Surgical Association (APSA) guidelines for the management of blunt liver and spleen injuries, designed as a “pocket card” with the easily recalled mnemonic “APSA” for Admission, Procedures, Set free, and Aftercare [13]. ICU = intensive care unit; q6hour = every six hours; CBC = complete blood count; NPO = nil per os; IVF = intravenous fluids; pRBC = packed red blood cells; CT = computed tomography.
See this image and copyright information in PMC

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