Management of paediatric blunt splenic injury in Zaria, Nigeria.

Abstract

The management of paediatric blunt splenic injury is predominantly non-operative in developed countries at the present time. In developing countries however, imaging facilities for diagnosis and monitoring are frequently not readily available. Over a decade, 32 children had blunt splenic injury in Zaria. 28 (87.5%) injuries were isolated. Nineteen (59.4%) had grade II or III injuries and their spleens were preserved (splenorrhaphy, 12; partial splenectomy, 4; laparotomy only, 2; observation, 1) while 13 (40.6%) had grade IV or V injury necessitating total splenectomy. There was no difference in blood transfusion requirements in any group. The average duration of hospital stay was 17 days for splenic preservation and 20 days for total splenectomy. Mortality was 2 (6.3%), both patients had total splenectomy and one had associated liver injury. With adequate facilities, laparotomy would have been avoided in 16 (51.6%) patients. It is hoped that as appropriate imaging facilities become more readily available in developing countries, less children with blunt splenic injury will be subjected to surgery.