Document Detail

What's the incidence of delayed splenic bleeding in children after blunt trauma? An institutional experience and review of the literature.
MedLine Citation:
PMID:  19741402     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The existence and incidence of delayed splenic bleeding (DSB) in children are controversial but the implications are significant. We sought to determine the incidence of DSB in children and to look for similarities between reported cases. METHODS: A retrospective cohort study of all children admitted from 1992 to 2006 to our level 1 pediatric trauma center with blunt splenic injuries to calculate the incidence of DSB. In addition, a systematic review of the literature was performed, looking for similarities between reported cases of DSB in children since 1980. RESULTS: Three hundred three children were admitted with blunt splenic injuries (mean age, 10 years +/- 4.5 years; boys 212 [70%]). Two hundred ninety-three (96%) were successfully managed nonoperatively. All-cause mortality was 20 of 303 (6.6%). We identified 1 of 303 (0.33%) children with DSB. The patient was a boy, aged 15 years. He presented 23 days after initial injury with DSB causing death. He had an uncomplicated admission after his initial grade IV injury. There have been 14 cases of DSB reported in the literature since 1980. Twelve (88%) were boys, with a mean age of 14 years +/- 4 years (with 11 of 14 (79%) being adolescent). The mean time to DSB was 10 days +/- 7 days. There were no similarities in mechanism, imaging characteristics, or presence of pseudoaneurysm between cases. CONCLUSION: DSB is exceedingly rare. Our institutional incidence is 1 of 303 (0.33%). The number and quality of reported cases is insufficient to draw conclusions on predisposing factors for DSB, however, most cases occur in adolescents.
Dafydd A Davies; Annie Fecteau; Sharifa Himidan; Angelo Mikrogianakis; Paul W Wales
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of trauma     Volume:  67     ISSN:  1529-8809     ISO Abbreviation:  -     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-10     Completed Date:  2009-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  573-7     Citation Subset:  AIM; IM    
Division of General Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
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MeSH Terms
Child, Preschool
Cohort Studies
Hemorrhage / diagnosis,  epidemiology*,  therapy
Retrospective Studies
Risk Factors
Spleen / injuries*
Time Factors
Wounds, Nonpenetrating / complications*,  diagnosis,  therapy

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