Introduction. Until now, there is an ongoing controversy regarding the curative strategy in spleen pseudoaneurysms which are detected by CT imaging.Purpose. To present a diagnostic and curative algorithm for treating spleen injury complicated by multiple pseudoaneurysms in a 13-year-old child.Observation. A 13-year-old boy was injured in a traffic accident (a cyclist hit by a car) and was admitted to the hospital by an ambulance with brain concussion, abrasions and bruises of soft tissues. On the second day after the injury, the child complained of the pain in the left lumbar region. Multiphase spiral computed tomography (MSCT) revealed damage of the lower pole of the spleen with formation of multiple round hyperdense formations in the arterial phase disappearing in the portal phase. Ultrasound examination revealed multiple hypoechoic zones up to 8 mm in diameter in the lower pole of the spleen, in which blood flow was seen at the color Doppler mapping (CDM). Diagnosis: closed trauma of the spleen, Grade 4 (AAST). Multiple pseudoaneurysms of the lower pole of the spleen. Repeated MSCT on the 6th day after the injury registered disappearance of pseudoaneurysms, like it was at the ultrasound examination. In six months after the injury, there were no complaints; spleen structure at ultrasound examination corresponded to age normal parameters.Conclusion. The presented clinical observation demonstrates the success of conservative treatment of spleen injury complicated by the formation of multiple pseudoaneurysms.

Introduction. The spleen is the most frequently injured abdominal organ in children. From the standpoint of the modern concept on the preventive and curative strategy, medical and epidemiological aspects of spleen injury in children in a metropolis are no less important than making a decision on performing surgery because of life-threatening indications.   Purpose. To find out medical and epidemiological features of spleen injury in children in a metropolis.   Material and methods. In 2013–2020, 518 children with injuries of the abdominal organs were treated in the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST). Of these, 213 children had spleen injury of varying severity. Gender, age of the injured children, mechanism, seasonality, severity, curative modalities and outcomes were analyzed.Results. Spleen injury accounted for 41.1 % in the structure of abdominal injuries. Most often, such injuries were seen in boys (144; 67.6 %) and in the warm season; average age of children was 9.9 ± 3.1 years. As a rule, spleen injury was met in cases of severe polytrauma with high-energy mechanisms (catatrauma 31.5%, traffic accidents – 30.6 %). Falls from bicycle/scooter/skateboard accounted for 8.5 %; sports injuries – for 4.2%. 31.5% of children were treated surgically, including splenectomy – 24.4 %. If children were primarily hospitalized to a specialized hospital, the effectiveness of conservative treatment was 94.1 %.   Conclusion. Most often, spleen injury is diagnosed in children with polytrauma. It means that our basic attention should be focused on preventive measures so as to decrease the incidence of pediatric injuries as a result of road accidents and catatrauma. Primary hospitalization in a specialized hospital promotes the highest efficiency of conservative treatment in case of spleen injury in children.