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of the North Caucasus
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Series ПИ #ФС 77-26521.
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ISSN 2073-8137

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Organ -preserving trends in the treatment of blunt splenic trauma in children

Anna Shapkina;

The results of conservative and operative treatment of 128 children with the blunt splenic trauma (BST) during last 21 years are presented. All patients have been examined and treated during the period from 1996 to 2016 in the Regional Children’s Hospital, Vladivostok, Russia. This period was divided into stages depending on the beginning of use of various diagnostic methods and getting more experience in their use. In the absence of CT authors have developed the algorithm of tactics in BST, including ultrasonography (US) and laparoscopy (LS). The ratio of splenectomies was more than 20 % initially and decreased to less level than 5 % of all cases.


1. Acker S. N., Petrun B., Partrick D. A., Roosevelt G. E., Bensard D. D. Lack of utility of repeat monitoring of hemoglobin and hematocrit following blunt solid organ injury in children. J. Trauma Acute Care Surg. 2015;79(6):991-994. doi: 10.1097/TA.0000000000000791
2. Adelgais K. M., Kuppermann N., Kooistra J., Garcia M., Monroe D. J. [et al.] Intra-Abdominal Injury Study Group of the Pediatric Emergency Care Applied Research Network (PECARN). Accuracy of the abdominal examination for identifying children with blunt intraabdominal injuries. J. Pediatr. 2014; 165(6):1230-1235. doi: 10.1016/j.jpeds.2014.08.014
3. Bairdain S., Litman H. J., Troy M., McMahon M., Almodovar H. [et al.] Twenty-years of splenic preservation at a level 1 pediatric trauma center. J. Pediatr. Surg. 2015; 50(5):864-868. doi: 10.1016/j.jpedsurg.2014.08.022
4. De Jong W. J., Nellensteijn D. R., Ten Duis H. J., Albers M. J., Moumni M. E. [et al.] Blunt splenic trauma in children: are we too careful? Eur. J. Pediatr. Surg. 2011; 21(4):234-237. doi: 10.1055/s-0031-1273692
5. Feliz A., Shultz B., McKenna C. Diagnostic and therapeutic laparoscopy in pediatric abdominal trauma. J. Pediatr. Surg. 2006;41(1):72-77. doi:10.1016/j.jpedsurg.2005.10.008
6. Forstner C., Plefka S., Tobudic S., Winkler H. M., Burgmann K. [et al.] Effectiveness and immunogenicity of pneumococcal vaccination in splenectomized and functionally asplenic patients. Vaccine. 2012;30(10):5449-5452. doi:10.1016/j.vaccine.2012.06.048
7. Hershkovitz Y., Zoarets I., Stepansky A., Kozer E., Shapira Z. [et al.] Computed tomography is not justified in every pediatric blunt trauma patient with a suspicious mechanism of injury. Am. J. Emerg. Med. 2014; 32(7):697-699. doi: 10.1016/j.ajem.2014.04.024
8. King H., Shumacher H. B. Susceptibility to infection after splenectomy performed in infancy. Ann. Surgery. 1952;6:239-244.
9. Kirkegård J., Avlund T. H., Amanavicius N., Mortensen F. V., Kissmeyer-Nielsen P. Non-operative management of blunt splenic injuries in a paediatric population: a 12-year experience. Dan. Med. J. 2015;62(2).
10. Kohler J. E., Chokshi N. K. Management of Abdominal Solid Organ Injury After Blunt Trauma. Pediatr. Ann. 2016;45(7):e241-246. doi: 10.3928/00904481-20160518-01
11. Miele V., Piccolo C. L., Trinci M., Galluzzo M., Ianniello S. [et al.] Diagnostic imaging of blunt abdominal trauma in pediatric patients. Radiol. Med. 2016;121(5):409-430. doi: 10.1007/s11547-016-0637-2
12. Nellensteijn D. R., Greuter M. J., El Moumni M., Hulscher J. B. The Use of CT Scan in Hemodynamically Stable Children with Blunt Abdominal Trauma: Look before You Leap. Eur. J. Pediatr. Surg. 2016;26(4):332-335. doi: 10.1055/s-0035-1554804
13. Nived P., Jørgensen C. S., Settergren B. Vaccination status and immune response to 13-valent pneumococcal conjugate vaccine inasplenic individuals. Vaccine. 2015;33(14):1688-1694. doi: 10.1016/j. vaccine.2015.02.026
14. Notrica D. M., Linnaus M. E. Nonoperative Management of Blunt Solid Organ Injury in Pediatric Surgery. Surg. Clin. North. Am. 2017;97(1):1-20. doi:10.1016/j.suc.2016.08.001
15. Ong A. W., Eilertson K. E., Reilly E. F., Geng T. A., Madbak F. [et al.] Nonoperative management of splenic injuries: significance of age. J. Surg. Res. 2016; 201(1):134-140. doi: 10.1016/j.jss.2015.10.014
16. Rosado M. M., Gesualdo F., Marcellini V., Di Sabatino A., Corazza G. R. [et al.] Preserved antibody levels and loss of memory B cells against pneumococcus and tetanus after splenectomy: tailoring better vaccination strategies. Eur. J. Immunol. 2013; 43(10):2659-2670. doi: 10.1002/eji.201343577
17. Rubin L. G., Levin M. J., Ljungman P., Davies E. G., Avery R. [et al.] Infectious Diseases Society of America.2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin. Infect. Dis. 2014; 58(3): 309-318. doi: 10.1093/cid/cit816
18. Singer G., Rieder S., Eberl R., Wegmann H., Hoellwarth M. E. Comparison of two treatment eras and sonographic long-term outcome of blunt splenic injuriesin children. Eur. J. Pediatr. 2013;172(9):1187-1190. doi: 10.1007/s00431-013-2022-7
19. Trejo-Ávila M. E., Valenzuela-Salazar C., Betancourt-Ferreyra J., Fernández-Enríquez E., Romero-Loera S. [et al.] Laparoscopic Versus Open Surgery for Abdominal Trauma: A Case-Matched Study. J. Laparoendosc. Adv. Surg. Tech. A. 2017;27(4):383-387. doi: 10.1089/lap.2016.0535

Keywords: blunt splenic trauma, children, conservative treatment

Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy