TITLE

Follow-Up Abdominal Computed Tomography after Splenic Trauma in Children May Not Be Necessary

AUTHOR(S)
Rovin, Joshua D.; Burns, R. Cartland; Rodgers, Bradley M.; Mcgahren, Eugene D.; Alford, Bennett A.; Mcilhenny, Joan
PUB. DATE
February 2001
SOURCE
American Surgeon;Feb2001, Vol. 67 Issue 2, p127
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Nonoperative management of splenic injuries in children is well accepted. However, the need for follow-up abdominal CT to document splenic healing has not been well studied. We retrospectively reviewed initial and follow-up abdominal CT examinations of pediatric patients admitted to our institution with documented splenic trauma who were managed nonoperatively. Eighty-four patients were admitted to our pediatric surgical service with splenic injury documented by CT from 1994 through 1998. The standard approach for splenic injury was bedrest for 5 to 21 days and limited activity for up to 90 days at the discretion of the attending surgeon. Thirty-five of the 84 had follow-up CTs during outpatient follow-up to evaluate and document splenic healing by CT criteria. The initial and follow-up studies were randomized and read blindly by pediatric radiologists using a modified American Association for the Surgery of Trauma grading system (I-V). The age range of the patients was 6 months to 17 years (mean +/- SE; 11 +/- 1 years). Nineteen (54%) were male and 16 (46%) were female. Causes of splenic trauma included motor vehicle accident (22), fall (seven), assault (four), pedestrian versus vehicle (one), and sports injury (one). Eight children (23%) had grade II injuries, 14 (40%) had grade III injuries, and 13 children (37%) had grade IV injuries on initial CT scan. Seven (88%) of the grade II splenic injuries were healed by 64 +/- 11 days. The remaining grade II injury had healed by 210 days. Thirteen (93%) of the grade III splenic injuries were healed by 76 +/- 7 days. The remaining grade III injury was healed by 140 days. Spleens in 10 (77%) of the 13 patients with grade IV injuries were healed by 81 +/- 8 days. Of the three remaining grade IV injuries two were healed by 173 +/- 14 days. The remaining patient's spleen was radiologically considered to have a grade III defect 91 days from the time of injury, and no further CTs were obtained. Of the 34 patients wh...
ACCESSION #
5180132

 

Related Articles

  • Splenic injuries in children: The challenges of non operative management in a developing country. Osifo, O. D.; Enemudo, R. E.; Ovueni, M. E. // Journal of Indian Association of Pediatric Surgeons;Oct-Dec2007, Vol. 12 Issue 4, p209 

    Aim: This is to report the challenges and experience gained with non operative management of splenic injuries in a developing country where sophisticated imaging facilities are either not available or exorbitantly expensive. Materials and Methods: All patients who presented with splenic injury...

  • Nonoperative Management of Blunt Splenic and Hepatic Trauma in the Pediatric Population: Significant Differences between Adult and Pediatric Surgeons? Jacobs, Ira A.; Kelly, Kathleen; Valenziano, Carl; Pawar, Joanne; Jones, Carol // American Surgeon;Feb2001, Vol. 67 Issue 2, p149 

    Although operative management was the preferred method of treating blunt abdominal trauma in the past, recent literature and practice recommend a nonsurgical approach to most pediatric splenic and hepatic injuries. The majority of data supporting the safety and efficacy of this nonoperative...

  • A life threatening complication after colonoscopy. Janes, Simon E. J.; Cowan, Ian A.; Dijkstra, Birgit // BMJ: British Medical Journal (International Edition);4/16/2005, Vol. 330 Issue 7496, p889 

    Presents a case study of splenic rupture following colonoscopy. Report that the most common complication of colonoscopy is bowel perforation; Details of the treatment of a woman with severe abdominal pain following colonoscopy; Diagnosis of splenic rupture after several tests and examinations...

  • The use of suggestion and behavioral methods in the treatment of aerophagia: Two case reports. Flaisher, Gad F. // Child & Family Behavior Therapy;1994, Vol. 16 Issue 4, p25 

    Presents two case reports on the treatment of aerophagia in children. Success in using covert desensitization and positive reinforcement of non-aerophagic behavior; Teaching of a response incompatible with air swallowing.

  • High dose growth hormone treatment induces acceleration of skeletal maturation and an earlier onset of puberty in children with idiopathic short stature. Kamp, G.A.; Waelkens, J.J.J.; Keizer-Schrama, S.M.P.F. de Muinck; Delemarre-van de Waal, H.A.; Verhoeven-Wind, L.; Zwinderman, A.H.; Wit, J.M. // Archives of Disease in Childhood;Sep2002, Vol. 87 Issue 3, p215 

    Background: Long term growth hormone (GH) treatment in children with idiopathic short stature (ISS) results in a relatively small mean gain in final height of 3-9 cm, which may not justify the cost of treatment. As it is unknown whether GH treatment during puberty adds to final height gain, we...

  • What is a reliable CT scan for diagnosing splenosis under emergency conditions? Garaci, Francesco Giuseppe; Grande, Michele; Villa, Massimo; Mancino, Stefano; Konda, Daniel; Attinà, Grazia Maria; Galatà, Gabriele; Simonetti, Giovanni // World Journal of Gastroenterology;8/7/2009, Vol. 15 Issue 29, p3684 

    Splenosis is a condition in which splenic tissue is present in a non-anatomical position. Implants of splenic tissue can mimic neoplasms and only specific examinations can confirm the correct diagnosis. Here we report a case of a 23-year-old male patient with a history of surgical splenectomy...

  • COMPUTED TOMOGRAPHY, SPLEEN. Schnell, Zoanne Burgess; Van Leeuwen, Anne M.; Kranpitz, Todd R. // Davis's Comprehensive Handbook of Laboratory & Diagnostic Tests ;Jan2003, p384 

    Presents a comprehensive guide to computed tomography of the spleen. Description of the purpose of the study and insight into how and why the test results can affect health; Use of the test in terms of assessment, evaluation and assisting in the diagnosis of a clinical condition; Interfering...

  • Inflammatory pseudotumour of the spleen: report of 2 cases and literature review. Jiqi Yan; Chenghong Peng; Weiping Yang; Chenghua Wu; Jiazeng Ding; Ting Shi; Hongwei Li // Canadian Journal of Surgery;Feb2008, Vol. 51 Issue 1, p75 

    The article presents two case studies of inflammatory pseudotumor of the spleen. The first case involves a 60-year-old man complaining of left upper abdominal discomfort and weight loss in the last six months. An abdominal computed tomography (CT) scan confirmed a low-density hypovascular mass...

  • Sarkoidozun Nadir Bir Tutulumu: Masif Splenomegali. Bircan, Ahmet; Kılıç, Özkan; Gökırmak, Münire; Öztürk, Önder; Akkaya, Ahmet // Turk Toraks Dergisi / Turkish Thoracic Journal;Jun2011, Vol. 12 Issue 2, p84 

    Sarcoidosis is a multisystemic granulomatous disease of unknown origin. Bilateral hilar lymphadenopathy, pulmonary infiltrates, and skin and ocular lesions are the most frequently detected manifestations. Although involvement of the spleen is frequent, it is quite rare to experience massive...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics