[Complications in the conservative managemennt of splenic rupture].

INTRODUCTION

Management of splenic rupture in haemodynamically stable children is non-surgical treatment. However, complications can occur during follow-up.

Objective

to study the frequency, evolution and treatment of complications of conservative treatment of splenic rupture. Secondary objective: to evaluate the results of the American Pediatric Surgical Association (APSA) clinical guideline in conservative treatment.

MATERIAL AND

METHODS

Retrospective study of patients with abdominal trauma between 2010-2016. We included children under 15 years of age with splenic injury after blunt abdominal trauma. Demographic variables, mechanism and degree of injury of American Association for the Surgery of Trauma were studied in the sample. The complications, the time of onset and their treatment were analyzed. The treatment was based on the recommendations of the APSA with the exception of ultrasound follow-up. In case of complications and according to the clinical and characteristics, embolization was indicated.

RESULTS

Twenty-eight patients were attended, 21 males (75%). The median age was 8.35 years (6.28-11.35). Seven patients (25%) presented complications: two arteriovenous fistula (AVF), three pseudo-aneurysms and two hemorrhages. The median time to diagnosis of complications was 5.67 days (P25 4- P75 5.75). Embolization was performed in two patients with pseudo-aneurysm. Another patient underwent emergency splenectomy for rebleeding. The rest of the complications resolved spontaneously.

CONCLUSIONS

In splenic rupture, unlike APSA, ultrasound monitoring is useful to rule out early complications.