title: Evolution of non-operative management for blunt splenic trauma in children.
abstract: Until the late 1960s, splenectomy was routinely performed in children who had sustained blunt splenic injury. There was based on the ability to perform splenectomy without obvious consequence; the cited 90-100% mortality for splenic trauma and the possibility of delayed rupture of the spleen. In contrast, contemporary findings in immunology and surgery demonstrated that non-operative management was not only feasible but desirable in view of the potential for overwhelming post-plenectomy infection. The history of universal splenectomy following blunt splenic trauma has been reviewed and we outline the findings that have resulted in the current standard of non-operative management following blunt splenic trauma.
authors.affiliation: Department of Academic Surgery, The Children's Hospital at Westmead, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Thompson
authors.forename: Andrew J A
authors.initials: AJ
authors.lastname: Holland
mesh_terms: D001803:Blood Transfusion; D002648:Child; D049673:History, 20th Century; D006801:Humans; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy; D013158:Splenic Diseases / Q000517:prevention & control; D014949:Wounds, Nonpenetrating / Q000266:history / Q000276:immunology / Q000601:surgery / Q000628:therapy*