Short summary

Follow-up imaging in blunt splenic injuries is a controversial part of acute care in the paediatric population. We analyze the management experience of OUH in the past 21 years in these patients and assess the available literature.

Rationale

Non-operative management (NOM) has become the standard of care in hemodynamically stable pediatric patients with blunt splenic injury (BSI) during the last four decades. The use of NOM rather than operative management has resulted in shorter hospital stays, fewer in-hospital complications and greater rates of splenic preservation with resulting conservation of immunologic function and minimization of overwhelming post-splenectomy infection. Failure of NOM (FNOM) is rare, with splenic salvation rates in the pediatric BSI population being >97 % in most studies. The NOM approach to BSI has brought with it several topics of investigation, including the role of follow-up imaging for the monitoring of splenic complications. The increasing sophistication of ultrasonographic scanning (US), with the advent of color Doppler ultrasonography (CDUS) and contrast-enhanced ultrasonography (CEUS), has begun to displace contrast-enhanced computed tomography (CECT) scanning as the modality of choice for follow-up imaging, primarily due to lower costs and radiation exposure concerns.

Description of the cohort

Children of both sexes aged 0-15 admitted to OUH with radiologically or operatively conformed blunt splenic injury in the study period (1996-2016).

Data and biological material

Demographic and radiological data, medical records. Rescans of patients done by ourselves.

Collaborating researchers and departments

Department of Surgery, Odense University Hospital

• Medical student Julie Ellen Madsen Lange
• Medical student Kiya Mirsharghi
• Professor Niels Qvist, MD

Department of Radiology, Odense University Hospital

• Pernille Wied Greisen