Medical and epidemiological aspects of spleen injury in children in a megapolis

Abstract

Introduction. The spleen is the most frequently injured abdominal organ in children. From the standpoint of the modern concept on the preventive and curative strategy, medical and epidemiological aspects of spleen injury in children in a metropolis are no less important than making a decision on performing surgery because of life-threatening indications. Purpose. To find out medical and epidemiological features of spleen injury in children in a metropolis. Material and methods. In 2013–2020, 518 children with injuries of the abdominal organs were treated in the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST). Of these, 213 children had spleen injury of varying severity. Gender, age of the injured children, mechanism, seasonality, severity, curative modalities and outcomes were analyzed.Results. Spleen injury accounted for 41.1 % in the structure of abdominal injuries. Most often, such injuries were seen in boys (144; 67.6 %) and in the warm season; average age of children was 9.9 ± 3.1 years. As a rule, spleen injury was met in cases of severe polytrauma with high-energy mechanisms (catatrauma 31.5%, traffic accidents – 30.6 %). Falls from bicycle/scooter/skateboard accounted for 8.5 %; sports injuries – for 4.2%. 31.5% of children were treated surgically, including splenectomy – 24.4 %. If children were primarily hospitalized to a specialized hospital, the effectiveness of conservative treatment was 94.1 %. Conclusion. Most often, spleen injury is diagnosed in children with polytrauma. It means that our basic attention should be focused on preventive measures so as to decrease the incidence of pediatric injuries as a result of road accidents and catatrauma. Primary hospitalization in a specialized hospital promotes the highest efficiency of conservative treatment in case of spleen injury in children.