[Treatment of splenic injuries in children].

Background: Most children with blunt splenic trauma are treated non-operatively. Controversy exists regarding the minimal hospital stay, follow-up imaging and length of activity restriction required after discharge.

Material And Methods: To evaluate outcome for this group of patients, a review was performed of children (age below 14) with blunt splenic injuries treated between January 2000 and December 2003.

Results: Fifteen children were admitted with blunt splenic trauma, all were successfully treated non-operatively. Four patients were excluded from further analysis because of multiple injuries that prolonged their hospital stay or they were transferred to our institution more than six days after the accident. Median age was 8 years (range, 1-12). Median length of stay was 5 days (range, 3-8) including 0 days (range, 0-4) in the intensive care unit. Median numbers of follow-up ultrasound examinations were 2 (range, 0-4) with no influence on treatment. Reduced activity after discharge was advised for a median of 4 weeks (3-6). All patients had an uneventful recovery.

Interpretation: Haemodynamically stable children with blunt splenic injuries can be treated non-operatively with short hospital stay and a few weeks of restricted activity after discharge. Routine follow-up imaging seems unnecessary.