Splenic injury from blunt abdominal trauma in children: follow-up evaluation with CT.

Abstract

To assess if the initial grade of splenic injury depicted at computed tomography (CT) in children could help predict rate of healing. Thirty-seven children with splenic injury graded at emergent CT were prospectively followed up with non-enhanced and contrast material-enhanced CT performed 2 weeks to 11 months after injury. In all 15 grade 1 and 2 splenic injuries, healing was seen at follow-up, including eight injuries that occurred in patients who underwent follow-up CT within 4 months. In 10 of 11 grade 3 splenic injuries, healing was seen within 6 months. In all 11 grade 4 injuries, residual lesions were seen within 4 months and healing took up to 11 months. Five of nine residual splenic injuries were more clearly visualized with contrast material enhancement. No splenic complications occurred. CT grade of splenic injury is related to rate of healing. Grade 1 and 2 injuries typically heal within 4 months, whereas grade 3 injuries take up to 6 months to heal and grade 4 injuries take up to 11 months.