• Jakob Kirkegård, Tue Højslev Avlund, Nerijus Amanavicius, Frank Viborg Mortensen, and Peter Kissmeyer-Nielsen.
• Abdominalkirurgisk Afdeling, Abdominalcentret, Aarhus Universitetshospital, Bygning 1C, Nørrebrogade 44, 8000 Aarhus C, Denmark. jakob.kirkegaard@auh.rm.dk.
• Dan Med J. 2015 Feb 1;62(2).

IntroductionNon-operative management (NOM) is now the primary treatment for blunt splenic injuries in children. Only one study has examined the use of NOM in a Scandinavian population. Thus, the purpose of this study is to report our experience in treating children with blunt splenic injuries with NOM at a Danish university hospital.MethodsWe conducted a retrospective observational study of 34 consecutive children (aged 16 years or less) admitted to our level 1-trauma centre with blunt splenic injury in the 12-year period from 1 January 2001 to 31 December 2012. Data on patients and procedures were obtained by review of all medical records and re-evaluation of all initial computed tomographies (CT).ResultsWe included 34 children with a median age of 10.5 years (67.6% males) in this study. All patients were scheduled for NOM, and two (5.9%) patients underwent splenic artery embolisation (SAE). Two (5.9%) patients later needed surgical intervention. The NOM success rate was 88% (95% confidence interval (CI): 73-97%) without SAE and 94% (95% CI: 80-99%) with SAE. We found no difference in the American Association for the Surgery of Trauma grade when comparing the initial CT evaluation (mean 2.59 ± 1.1) with the CT re-evaluation (mean 2.71 ± 0.94); p = 0.226.ConclusionWe demonstrated a high degree of success and safety of non-operative treatment in children with blunt splenic injury in a Scandinavian setting. Our results are comparable to international findings.

25 keywords...

hide…