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



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   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.

作者简介

A. Gorelik

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

编辑信件的主要联系方式.
Email: Dr.A.Gorelik@gmail.com
ORCID iD: 0000-0003-1746-8446

Alexander L. Gorelik, MD

119180

department of polytrauma

Moscow

俄罗斯联邦

O. Karaseva

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma; National Medical Research Center for Children’s Health

Email: fake@neicon.ru
ORCID iD: 0000-0001-9418-4418

119180

119296

Moscow

俄罗斯联邦

A. Timofeeva

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: fake@neicon.ru
ORCID iD: 0000-0002-6940-4535

119180

Moscow

俄罗斯联邦

D. Golikov

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: fake@neicon.ru
ORCID iD: 0000-0001-5982-5494

119180

Moscow

俄罗斯联邦

O. Yanyushkina

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: fake@neicon.ru
ORCID iD: 0000-0002-6227-466X

119180

Moscow

俄罗斯联邦

参考

  1. Апарцин К. А. В кн.: Абдоминальные травмы у детей / К. А. Апарцин [и др.] ; под ред. В. В. Подкаменева [и др.] – М.: ГЭОТАР-Медиа, 2019. ISBN 978-5-9704-5424-4 – Apartsin K. A., Belyaeva O. A., Grigoriev E. G., et al. In: Abdominal injuries in children. Eds. by V. V. Podkamenev, V. M. Rozinov, E. G. Grigoriev, Yu. A. Kozlov [Abdominal'nye travmy u detej. Pod red. V. V. Podkameneva, V. M. Rozinova, E. G. Grigoreva, Yu. A. Kozlova]. Moscow: GEOTAR-Media; 2019. ISBN 978-5-9704-5424-4 (In Russian)
  2. Fodor M., Primavesi F., Morell-Hofert D., Kranebitter V., Palaver A., Braunwarth E., Haselbacher M., Nitsche U., Schmid S., Blauth M., Gassner E., Öfner D., Stättner S. Non-operative management of blunt hepatic and splenic injury: a time-trend and outcome analysis over a period of 17 years. World J Emerg Surg. 2019; (17): 14–29. PMID: 31236129; PMCID: PMC 6580509; https://doi.org/10.1186/s13017-019-0249-y
  3. Coccolini F., Montori G., Catena F., et al. Splenic trauma: WSES classification and guidelines for adult and pediatric patients. World J Emerg Surg. 2017; 18: 12–40. PMID: 28828034; PMCID: PMC 5562999; URL: https://wjes.biomedcentral.com/articles/10.1186/s13017-017-0151-4
  4. Kruetzmann S., Rosado M. M., Weber H. et al. Human immunoglobulin M memory B cells controlling Streptococcus pneumoniae infections are generated in the spleen. J Exp Med. 2003; 197(7): 939–45.
  5. Морозов Д. А. Менингококковая инфекция в раннем послеоперационном периоде органосохраняющего хирургического лечения травмы селезенки / Д. А. Морозов [и др.] // Российский вестник детской хирургии, анестезиологии и реаниматологии. – 2016. – 6 (2): 93–7. [Morozov D. A., Klyuev S. A., Tatochenko V. K., Bakradze M. D. Meningococcal infection in the early postoperative period of organ-preserving surgical treatment of spleen injury. Rossijskij vestnik detskoj hirurgii, anesteziologii i reanimatologii. 2016; 6 (2): 93–7. (In Russian)
  6. Подкаменев В. В. Концепция спонтанного гемостаза при травме селезёнки у детей / В. В. Подкаменев, И. А. Пикало // Медицинский вестник Северного Кавказа. – 2016. – 11 (3): 409–13. https://doi.org/10.14300/mnnc.2016.11090 – Podkamenev V. V., Pikalo I. A. The concept of spontaneous hemostasis in spleen injury in children. Medicinskij vestnik Severnogo Kavkaza. 2016; 11 (3): 409–13. https://doi.org/10.14300/mnnc.2016.11090 (In Russian)
  7. Vlies H., Delden O. M., Punt B. J., Ponsen K. J., Reekers J. A., Goslings J. C. Literature Review of the Role of Ultrasound, Computed Tomography, and Transcatheter Arterial Embolization for the Treatment of Traumatic Splenic Injuries. Cornelis Cardiovasc Intervent diol. 2010; 33 (6): 1079–87. Published online 2010 Jul 29. https://doi.org/10.1007/s00270-010-9943-6
  8. Ахадов Т. А. Лучевая диагностика травмы живота у детей / Т. А. Ахадов [и др.] // Детская хирургия. – 2018. – 22 (1): 21–8. https://doi.org/10.18821/1560-9510-2018-22-1-21-28. – Akhadov T. A., Karaseva O. V., Chernyshova T. A., Semenova N. A., Melnikov I. A., Ublinsky M. V., Manzhurtsev A. V., Menshchikov P. E. Radiation diagnosis of abdominal trauma in children. Detskaya hirurgiya. 2018; 22 (1): 21–8. https://doi.org/10.18821/1560-9510-2018-22-1-21-28 (In Russian)
  9. Notrica D. M., Eubanks J. W. 3 rd , Tuggle D. W., et al. Nonoperative management of blunt liver and spleen injury in children: evaluation of the ATOMAC guideline using GRADE. J Trauma Acute Care Surg; 2015; 79 (4): 683–93.
  10. Stylianos S. To save a child’s spleen: 50 years from Toronto to ATOMAC. J Pediatr Surg; 2019; 54 (1): 9–15. Epub 2018 Oct 9. PMID: 30404720. URL: https://pubmed.ncbi.nlm.nih.gov/30404720/
  11. Карасева О. В. Тактика хирурга при травме селезёнки у детей. В кн.: Травма 2017: мультидисциплинарный подход / О. В. Карасева [и др.] // Сборник тезисов Международной конференции (г. Москва, 3–4 ноября 2017 года). – Воронеж: Научная кн., 2017. – 176–7. ISBN 978-5-4446-1049-7. – Karaseva O. V., Gorelik A. L., Timofeeva A. V., Granikov O. D., Golikov D. E., Chernysheva T. A., Akhadov T. A., Khorchinova E., Roshal L. M. Surgical tactics for spleen injury in children. In: Trauma 2017: A multidisciplinary approach. Collection of abstracts of the International Conference (Moscow, November 3–4, 2017) [Travma 2017: mul'tidisciplinarnyj podhod. Sbornik tezisov Mezhdunarodnoj konferencii (g. Moskva, 3–4 noyabrya 2017 goda)]. Voronezh: Nauchnaya kn., 2017; 176–7. ISBN 978-5-4446-1049-7 (In Russian)
  12. Румянцева Г. Н. К вопросу о современном подходе к диагностике и лечению травм селезенки у детей / Г. Н. Румянцева [и др.] // Журнал им. Н. В. Склифосовского «Неотложная медицинская помощь». – 2021. – 10 (1): 168–73. URL: https://www.jnmp.ru/jour/article/view/1085/933 – Rumyantseva G. N., Kazakov A. N., Volkov S. I., Yusufov A. A., Brevdo Yu. F., Portenko Yu. G. On the question of a special approach to the diagnosis and special traumatism of the spleen in children. Zhurnal im. N. V. Sklifosovskogo "Neotlozhnaya medicinskaya pomoshch'". 2021; 10 (1): 168–73. https://doi.org/10.23934/2223-9022-2021-10-1-168-173 (In Russian)
  13. Baker S. P., O’Neill B., Haddon W. Jr., Long W. B. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma; 1974; 14 (3): 187–96.
  14. Moore E. E., Shackford, S. R., Pachter, H. L., Mcaninch J. W., Browner B. D., Champion H. R., Flint L. M., Gennarelli T. A., Malangoni M. A., Ramenofsky M. L., Trafton P. G. Organ Injury Scaling: Spleen, Liver and Kidney. The Journal of Trauma: Injury, Infection, and Critical Care; 1989; 29 (12): 1664–6.
  15. Kozar R. A., Crandall M., Shanmuganathan K., et al. Organ injury scaling 2018 update: Spleen, liver, and kidney. J Trauma Acute Care Surg. 2018; 85: 1119–22.
  16. Liu S., Bowman S. M., Smith T. C., Sharar S. R. Trends in pediatric spleen management: Do hospital type and ownership still matter? J Trauma Acute Care Surg; 2015; 78 (5): 935–42. PMID: 25909412. https://doi.org/10.1097/TA.0000000000000621

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