Current Developments of Fibrin Glue in the Treatment of Splenic Injury Splenic injury is a common problem of surgical daily routine. It often happens in consequence of blunt abdominal trauma. Because of rare but very grave complications after splenectomy, changing of the treatment to preserve the spleen has been established in the last years. Today the surgeon has a good and safe way to achieve hemostasis by using fibrin glue. The fibrin glue has got a key position in the management of the treatment of splenic injury. Various stages of spleen rupture and the treatment opportunities including fibrin glue in addition to other treatments like collagenic fleece or wrapping by absorbable mesh will be shown. In the future we expect new possibilities of laparoscopic treatment depending on the development of laparoscopic equipment.

A 9 year old boy presented with uncharacteristic gastroenteric complaints due to a complete heart block 9 days after an uneventful varicella infection. Echocardiographically there were no signs of gross myocardial involvement. Bradydysrhythmia necessitated isoproterenol application however without the need for temporary transvenous cardiac pacing. After a short period of second-degree atrioventricular block and transient left bundle branch block the rhythm recovered completely and sinus rhythm is maintained so far. Worrying is the delayed onset of this complication after an uneventful course of a typically undangerous children's disease. Presumably a remaining inflammatory reaction in different parts of the specific conducting system has to be assumed. The long lasting prognosis of the atrioventricular conduction properties remains to be seen.

A 16-month-old boy suffers a massive trauma (open dislocated pelvic fracture and decollement with haemorrhagic shock) due to a traffic accident. We present the characteristics and obstacles in the prehospital and early hospital emergency care of this severe and rare trauma in a pediatric patient with an emphasis on medical-operational tactics.