[Conservative approach to blunt hepatic and splenic trauma in childhood--experiences in the Pediatric Surgery Department, Soroka Hospital in the years 1980-1994].
42 children with blunt hepatic and splenic trauma, seen from 1980-1994, were treated conservatively, but 15 with splenic and 2 with hepatic trauma underwent surgery (7 had splenic preservation procedures: partial splenectomy or splenorrhaphy). Boys predominated, the mean age was 8.6 years and the main cause of injury was road accidents. In most cases hemodynamic instability within the first 24 hours was the most significant factor in determining the appropriate approach. Those who were hemodynamically stable after this period could be safely managed without operation. No complications were attributed to either operative or conservative treatment. In 5 cases there were mild respiratory or urinary tract infections unrelated to the initial trauma; there were no deaths. The overall results support the prevailing conservative approach to the treatment of blunt splenic and hepatic trauma in the hemodynamically stable child. CAT is our preferred diagnostic imaging modality in the acute phase, and ultrasonography in the follow-up period.
Shoavi
U
U
Dept. of Pediatric Surgery, Soroka Medical Center, Beer Sheba.
Mares
A J
AJ
D000063:Accidents, Traffic; D002648:Child; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008099:Liver / Q000293:injuries*; D008297:Male; D012189:Retrospective Studies; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*