Pleuro-pulmonary involvement in children with blunt splenic trauma.
OBJECTIVE
Evaluation of the importance of pleuro-pulmonary involvement in paediatric patients with blunt splenic trauma.


METHODS
A retrospective chart review of 27 patients, aged 2-16 years, treated for blunt splenic injury between 1992 and 1999 was performed.


RESULTS
All patients except one were treated conservatively. In 12 patients (44.4%) left-sided pleuro-pulmonary involvement was diagnosed as primary traumatic injury or as a late complication. While Grade I and II splenic injuries were prevalent, pleuro-pulmonary involvement patients had a more severe degree of splenic injury. Chest pain, dyspnoea and diminished respiratory sounds were present on primary examination in patients with chest trauma. Body temperature during the first 5 post-trauma days was significantly higher among pleuro-pulmonary involvement patients. Specific pleuro-pulmonary involvement diagnoses on admission in six children with primary chest trauma were: lung contusion, pleural thickness, or haemo-pneumothorax. Three of them developed delayed pleural effusion. In the other six children with pleuro-pulmonary involvement, late complications appeared during 2-5 days post-trauma.


CONCLUSIONS
Pleuro-pulmonary involvement was observed in almost half of patients with blunt splenic trauma. Pleuro-pulmonary involvement occurred either early as a result of direct chest trauma or was delayed. High suspicion, careful monitoring of body temperature and repeated chest X-ray studies are recommended for early diagnosis and treatment of delayed pleuro-pulmonary involvement.
Gorenstein
A
A
Department of Paediatric Surgery, Edith Wolfson Medical Center, PO Box 5, Holon 58100, Israel.
Witzling
M
M
Haftel
L T
LT
Mandelberg
A
A
Serour
F
F
D000293:Adolescent; D001831:Body Temperature; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008171:Lung Diseases / Q000150:complications*; D008297:Male; D012189:Retrospective Studies; D013154:Spleen / Q000293:injuries*; D013898:Thoracic Injuries / Q000150:complications*; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000150:complications* / Q000628:therapy