Splenectomy after blunt abdominal trauma. A retrospective study of 413 children.

Splenectomies performed in children aged 0-14 during the period 1968-1977 have been reviewed. In 413 cases traumatic rupture of the spleen had occurred. The trauma causing the rupture, preoperative examinations, operative findings and complications have been studied. Most frequently traffic accidents had caused the splenic rupture. Many ruptures were not bleeding at the time of operation. Consequently surgical repair saving the spleen had been possible in several cases. Splenectomized children have a significant increased risk of overwhelming sepsis. In this retrospective material 10 children (2.4%) developed sepsis within eight years. Five of these cases had a fatal outcome. The need for a more conservative attitude in children with splenic rupture is emphasized.