Observation of splenic trauma: when is a little too much?
A 12-year-old boy was treated conservatively for a grade II splenic laceration. On discharge, he was instructed to avoid contact sports, running, and strenuous physical activity. Thirty-eight days later, after diving off the side of a swimming pool, he had abdominal pain, nausea, and diaphoresis. On admission, he was hemodynamically unstable. Results of a diagnostic lavage showed gross blood. At laparotomy, a fractured spleen was found, and splenectomy was performed. He recovered without complication. This case questions the activity restrictions placed on patients with conservatively managed splenic trauma. Avoidance of only contact sports and heavy exertion may be inadequate.
Brown
R L
RL
Department of Surgery, Children's Hospital of Buffalo and State University of New York at Buffalo, School of Medicine and Biomedical Sciences, 14222, USA.
Irish
M S
MS
McCabe
A J
AJ
Glick
P L
PL
Caty
M G
MG
D002648:Child; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D019370:Observation; D012865:Skiing / Q000293:injuries; D013154:Spleen / Q000293:injuries* / Q000601:surgery*; D013156:Splenectomy; D013161:Splenic Rupture / Q000209:etiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000628:therapy*