Non-Operative Management of Traumatized Spleen in Children: The Role of Open Abdominal Tap

Abstract

Experience with non-operative management of paediatric splenic trauma in 12 children, and current treatment protocol are presented. Splenic injury was confirmed in all instances by scintiscan. Under close observation no evidence of rebleeding was found. In one patient with persistent fever, peritoneal irritation and leukocytosis open abdominal tap was performed in order to eliminate other intra-abdominal injury and conservative treatment continued. Average stay in hospital was 11 days. Patients recovered fully by six weeks and repeat scintiscan at three months were normal in 9 patients and greatly improved in the other three. Most children sustaining splenic injury may be non-operatively managed. In a special subgroup of moderate bleeders open abdominal tap may increase the safety of this approach and reduce the number of superfluous laparotomies to a minimum.