HOW TO AVOID SPLENECTOMY IN A CHILD WITH SPLENIC TRAUMA
https://doi.org/10.17238/PmJ1609-1175.2018.1.72-74
Abstract
Objective. In case of traumatic spleen injury, splenectomy is often performed. Authors in such a situation tried to adhere to the organ-preserving and conservative approach presenting in this work an algorithm for managing such patients. Methods. Data on 36 cases of spleen damage with closed abdominal trauma in children 2-14 years old, who were admitted to the Regional Children's Clinical Hospital No. 1 in 2008-2017 are presented. Results. The most informative and constant laboratory index of spleen damage with closed abdominal injury was leukocytosis registered in 94.3 % of cases. Conservative treatment was started by 29 patients and was successful in 28 cases, laparoscopy was performed for 5 children, and there were no conversions in this group. Three laparotomies were performed: resection of the superior pole of the spleen and two splenectomies (one with autotransplantation of the splenic tissue into the large omentum). Mortality was 2.8 % - a child died with organ rupture following the acute leucosis. Conclusions. Conservative treatment in case of hemodynamic stability in patients with spleen injuries should be a method of choice. Failures of conservative treatment do not lead to mortality increase. In case of laparotomy the preference should be given to organ-saving methods - resection of an organ and splenography.
About the Authors
A. N. Shapkina
Тихоокеанский государственный медицинский университет
Russian Federation
Russian Federation
M. V. Kozlova
Краевая детская клиническая больница № 1
Russian Federation
Russian Federation
E. S. Shmyreva
Краевая детская клиническая больница № 1
Russian Federation
Russian Federation
V. B. Shumatov
Тихоокеанский государственный медицинский университет
Russian Federation
Russian Federation
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Review
For citations:
Shapkina A.N., Kozlova M.V., Shmyreva E.S., Shumatov V.B. HOW TO AVOID SPLENECTOMY IN A CHILD WITH SPLENIC TRAUMA. Pacific Medical Journal. 2018;(1):72-74. (In Russ.) https://doi.org/10.17238/PmJ1609-1175.2018.1.72-74
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