Splenic injury diagnosed with CT: US follow-up and healing rate in children and adolescents.

Abstract

To determine if pediatric splenic injury healing observed during ultrasonography (US) is related to the computed tomographic (CT) grade of injury severity, to review any delayed complications, and to formulate a grade-specific timetable for follow-up imaging. Sixty-eight children and adolescents with CT-documented blunt splenic injury underwent US at approximate 6-week intervals to document injury healing (normal parenchyma or linear echogenic "scar"). Medical records of those not followed up to complete healing were reviewed. Forty-eight patients were followed up to complete injury healing: 14 of injury grade 1 (mean, 7 weeks; range, 4-12 weeks), 24 of injury grade 2 (mean, 9.5 weeks; range, 6-17 weeks), and 10 of injury grade 3 (mean, 16 weeks; range, 6-29 weeks). The difference in mean time to healing among all grades was significant (P < .02). Only two cysts were found; one decreased in size over time. No complications occurred in the 68 study patients. The time course to US-documented healing of blunt pediatric splenic injury is related to injury severity. This information can be used to tailor follow-up imaging and provide cost savings.