BACKGROUND: The objective of this study is to compare nonoperative and surgical treatment of splenic injuries in children. METHODS: The charts of 32 patients with blunt splenic injuries were examined prospectively. Of these, 16 were submitted to nonoperative treatment (Group I) and 16 underwent surgical approach (Group II). The criteria for nonoperative treatment were hemodynamic stability, Glasgow coma scale > 12, absence of other visceral injuries. Blood transfusion and intensive care unit stay, hospital stay length, associated injuries, RTS, TRISS and clinical course were analyzed. The imaging methods were ultrasonography and computer tomography. RESULTS: In group I there were more injuries of grade II and III and in group II there were more lesions of grade IV and V. The main associated injuries were the craniocerebral and extremities ones and only in group II gastrointestinal tract injuries were diagnosed. Group I patients had 100% success in therapy. CONCLUSION: Most children with hemodynamically stable splenic injuries after blunt abdominal trauma can be treated sucessfully with nonoperative aproach. We recommend to investigate and document the lesion with image ( ultrasonography or computer tomography).
Wound and injuries; Spleen; Surgery; Child
