ABSTRACT

Aim: To determine the outcome of non-operative management (NOM) in treatment of splenic injury in children with blunt abdominal trauma.

Study design:Cross sectional study.

Place and duration of study: Department of Paediatric Surgery, Nishtar Medical University Hospital Multan during July 2017 to June 2019.

Methods: In this study the cases of both gender and age less than 14 years suffering from blunt abdominal trauma with splenic injury were included. The injury was confirmed and graded on computed tomography scan. Then these cases were conservatively and medically managed, following non-operative management strategy. The cases with worsening hemodynamic were subjected to surgery. The patients were observed till full recovery and discharge from hospital. Mode of injury, grade of injury, initial haemoglobin, transfusion requirements, hospital stay and outcome were noted. Angiography and angioembolization were not used due to non-availability.

Results:In this study there were 21 cases. 18 (85.7%) were male. The mean age of the participants was 7.36 ± 3.28 years. Regarding outcomes complete recovery was seen in 18 (85.7%) of the cases, splenectomy was done in 3 (14.7%). Splenectomy was needed in patients having grade IV or grade V injury. Mean hospital stay was 6.76 ±4.83 days.

Conclusion: Non-operative management of blunt splenic injury is the treatment of choice. Spleen can be salvaged and usually least complications are associated with this strategy.

Key words: Spleen, non-operative management, splenectomy, trauma