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The incidence of delayed splenic bleeding in pediatric blunt trauma.

Authors :
Notrica DM
Sayrs LW
Bhatia A
Letton RW
Alder A
St Peter S
Ponsky TA
Eubanks JW 3rd
Lawson KA
Ostlie DJ
Tuggle DW
Garcia NM
Maxson RT
Leys C
Greenwell C
Source :
Journal of pediatric surgery [J Pediatr Surg] 2018 Feb; Vol. 53 (2), pp. 339-343. Date of Electronic Publication: 2017 Oct 08.
Publication Year :
2018

Abstract

Background: One of the concerns associated with nonoperative management of splenic injury in children has been delayed splenic bleed (DSB) after a period of hemostasis. This study evaluates the incidence of DSB from a multicenter 3-year prospective study of blunt splenic injuries (BSI).<br />Methods: A 3-year prospective study was done to evaluate nonoperative management of pediatric (≤18years) BSI presenting to one of 10 pediatric trauma centers. Patients were tracked at 14 and 60days. Descriptive statistics were used to summarize patient and injury characteristics.<br />Results: During the study period, 508 children presented with BSI. Median age was 11.6 [IQR: 7.0, 14.8]; median splenic injury grade was 3 [IQR: 2, 4]. Nonoperative management was successful in 466 (92%) with 18 (3.5%) patients undergoing splenectomy at the index admission, all within 3h of injury. No patient developed a delayed splenic bleed. At least one follow-up visit was available for 372 (73%) patients.<br />Conclusion: A prior single institution study suggested that the incidence of DSB was 0.33%. Based on our results, we believe that the rate may be less than 0.2%.<br />Level of Evidence: Level II, Prognosis.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1531-5037
Volume :
53
Issue :
2
Database :
MEDLINE
Journal :
Journal of pediatric surgery
Publication Type :
Academic Journal
Accession number :
29079311
Full Text :
https://doi.org/10.1016/j.jpedsurg.2017.10.005