Follow-up Imaging Studies in Children with Splenic Injuries

We undertook a retrospective study of pediatric blunt splenic injuries treated nonoperatively at our institution from 1990 to 1995 (n=72) to assess the impact of serial computed tomography (CT) scans on the outcome. Median number of studies per child was three. The result showed that the appearance of the splenic injury remained unchanged or improved in 95% of the imaging studies obtained (116 of 122). Only one of five patients with an image suggesting a worsening splenic injury required operative intervention. There were no instances of missed injuries, delayed ruptures, or readmissions. We conclude that serial CT scans have limited follow-up value and should be used selectively.

[1]  G. Taylor Imaging of pediatric blunt abdominal trauma: what have we learned in the past decade? , 1995, Radiology.

[2]  D. Bulas,et al.  Splenic injury from blunt abdominal trauma in children: follow-up evaluation with CT. , 1995, Radiology.

[3]  J. Jacobson,et al.  Splenic trauma: value of follow-up CT. , 1995, Radiology.

[4]  A. Coran,et al.  Resolution of splenic injury after nonoperative management. , 1994, Journal of pediatric surgery.

[5]  V. Raptopoulos Abdominal trauma. Emphasis on computed tomography. , 1994, Radiologic clinics of North America.

[6]  L. Mansi,et al.  Conservative treatment in splenic trauma. , 1993, Journal of the Royal College of Surgeons of Edinburgh.

[7]  Smith Js,et al.  Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen. , 1992 .

[8]  R. Touloukian,et al.  Outcome of nonoperative management of splenic injury with nuclear scanning. Clinical significance of persistent abnormalities. , 1992, American journal of diseases of children.

[9]  J. S. Smith,et al.  Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen. , 1992, The Journal of trauma.

[10]  J. Cronan,et al.  CT appearance of splenic injuries managed nonoperatively. , 1991, AJR. American journal of roentgenology.

[11]  H. Champion,et al.  Organ injury scaling: spleen, liver, and kidney. , 1989, The Journal of trauma.

[12]  Grosfeld Jl,et al.  Splenic and liver trauma in children. , 1989 .

[13]  R. Jeffrey CT diagnosis of blunt hepatic and splenic injuries: a look to the future. , 1989, Radiology.

[14]  D. Gens,et al.  Blunt splenic trauma in adults: CT-based classification and correlation with prognosis and treatment. , 1989, Radiology.

[15]  F. Rescorla,et al.  Splenic and liver trauma in children. , 1989, Indiana medicine : the journal of the Indiana State Medical Association.

[16]  W. M. Hopkins,et al.  Nonoperative management of blunt splenic trauma in the adult: a community hospital's experience. , 1987, The Journal of trauma.

[17]  E. Sauerbrei,et al.  Healing in the traumatized spleen: sonographic investigation. , 1984, Radiology.

[18]  Y. Ben-menachem,et al.  The management of splenic injury. , 1982, The Journal of trauma.

[19]  T. Lobe,et al.  Selective management of injured spleen. , 1981, Surgery.

[20]  D. Cooney,et al.  The role of computed tomography in the evaluation of blunt abdominal trauma in children. , 1981, Journal of pediatric surgery.

[21]  B. Shandling Conservative management of ruptured spleen. , 1980, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[22]  K. Solheim Non-operative management of splenic rupture. , 1979, Acta chirurgica Scandinavica.

[23]  S. Ein,et al.  Nonoperative management of traumatized spleen in children: how and why. , 1978, Journal of pediatric surgery.

[24]  J. Ash,et al.  Splenic trauma--nonoperative management and long-term follow-up by scintiscan. , 1978, Journal of pediatric surgery.

[25]  S. Treves,et al.  Scintigraphy in the followup of pediatric splenic trauma treated without surgery. , 1978, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[26]  A. Scherz,et al.  Nonoperative management of splenic trauma in children: a report of six consecutive cases. , 1977, Pediatrics.