Results of non-operative management of splenic trauma and its complications in children

Abstract

Introduction:Non-operative management (NOM) of splenic trauma in children is currently the treatment of choice.Purpose:We report a series of 83 cases in order to compare our results with literature data.Patients and Methods:For this, we conducted a retrospective study of 13 years and collected 83 cases of children with splenic trauma contusion, managed at Lapeyronie Montpellier Hospital in Visceral Pediatric Surgery Department. The studied parameters were age, sex, circumstances, the blood pressure (BP), hematology, imaging, associated injuries, transfusion requirements, treatment, duration of hospital stay, physical activity restriction and evolution.Results:NOM was successful in 98.7% of cases. We noted 4 complications including 3 pseudo aneurysms (PSA) of splenic artery and 1 pseudocyst spleen with a good prognosis. There was no mortality in our series.Conclusion:NOM is the treatment of choice for splenic trauma in children with a success rate of over 90%. Complications are rare and are dominated by the PSA of splenic artery.

Systematic review of grading systems for adverse surgical outcomes

“…This becomes increasingly of concern when assessing pediatric and trauma populations, as the prevalence of nonoperative management of diseases that were previously treated surgically is increasing. [13][14][15] Given the differing inherent qualities of each complication grading system in existence, this systematic review aimed to enumerate the current systems for grading adverse surgical outcomes. Our secondary objective was to outline the properties of each grading system to better characterize their strengths and weaknesses.…”