title: Comparison of two treatment eras and sonographic long-term outcome of blunt splenic injuries in children.
abstract: The treatment of blunt splenic injuries (BSI) has undergone a significant shift away from an operative approach to a conservative treatment regimen in the last decades. Data concerning long-term follow-up of children sustaining BSI are largely confined to telephone surveys. Children treated with BSI over a 33-year period were analyzed. In order to describe the changing treatment, patients were divided into two groups: group I included children treated between 1977 and 1999; group II children treated between 2000 and 2009. Additionally, patients treated nonoperatively between 2000 and 2009 were invited for a sonographic follow-up examination. In group I 81 patients and in group II 89 patients were treated. An increase of male patients from 69 to 88 % was observed, comparing the two eras. While children treated in the earlier period were 8.8-years-old mean (range 1 to 15), the patients treated between 2000 and 2009 were older (mean 10.4 years, range 1 to 17). Between 1977 and 1999, 79 % of the patients were treated nonoperatively. This rate considerably increased to 94 % in the second era. Follow-up examination was performed with a mean age of 6 years (range 1 to 11 years) post-injury. In 79 % of the cases, the spleen healed without sonographic long-term sequelae. In the remaining 21 % of the patients, a scar formation could be demonstrated.
  
  
  CONCLUSIONS
  We were able to confirm that the majority of children sustaining BSI can be safely treated conservatively.
authors: Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria. georg.singer@medunigraz.at
authors: Georg
authors: G
authors: Singer
authors: Stefan
authors: S
authors: Rieder
authors: Robert
authors: R
authors: Eberl
authors: Helmut
authors: H
authors: Wegmann
authors: Michael E
authors: ME
authors: Hoellwarth
mesh_terms: D000293:Adolescent; D001317:Austria; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*
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