Long-term outcome of nonoperative pediatric splenic injury management.
BACKGROUND
Nonoperative management (NOM) of blunt splenic trauma is the standard of care in hemodynamically stable children. The long-term risk of this strategy remains unknown. The object of this study was to investigate the incidence of long-term complications after NOM of pediatric splenic injury.


METHODS
All children who underwent NOM for blunt splenic trauma over an 11-year period were identified. Patients were interviewed for any ailments that could be related to their splenic injury, and hospital data were analyzed.


RESULTS
A total of 266 patients were identified, and 228 patients (86%) were interviewed. Mean follow-up time was 5 +/- 3 years. One patient had a delayed complication, a splenic pseudocyst. Pain more than 4 weeks after injury was unusual. Time until return to full activity varied broadly.


CONCLUSIONS
The incidence of long-term complications after NOM of pediatric splenic injury was 1 (0.44%) in 228 patients. Nonoperative management of pediatric blunt splenic trauma in children is associated with a minimal risk of long-term complications.
Kristoffersen
Kristian W
KW
Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
Mooney
David P
DP
D015746:Abdominal Pain / Q000209:etiology; D000058:Accidental Falls; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D001642:Bicycling / Q000293:injuries; D001900:Boston / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003560:Cysts / Q000209:etiology; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D012306:Risk; D013154:Spleen / Q000293:injuries*; D013158:Splenic Diseases / Q000209:etiology; D014193:Trauma Centers / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000628:therapy*