Current views on the diagnosis and treatment of spleen injuries in children

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Abstract

The study highlights current problems arising from the use of various surgical techniques for the treatment of spleen injuries and their consequences. Through a literature review, we aimed to determine the structure of spleen injuries and peculiarities of their diagnosis and treatment in children and identify the main indications, consequences, and selection criteria for spleen surgery techniques. A comparison of different assessment methods and surgical techniques and determination of the most optimal method that improves patients’ quality of life are presented. An algorithm of procedures for closed abdominal trauma in children is specified.

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Igor I. Rozenfel'd

Tver State Medical University

Author for correspondence.
Email: iiggo@mail.ru
ORCID iD: 0000-0002-0702-676X

MD, Cand. Sci. (Med.)

Russian Federation, 4, Sovetskaya str., Tver, 170003

Daniella L. Chilikina

Tver State Medical University

Email: daniellaleonidovna@mail.ru
Russian Federation, 4, Sovetskaya str., Tver, 170003

Ani M. Varpetyan

Tver State Medical University

Email: varpetyan01@mail.ru
Russian Federation, 4, Sovetskaya str., Tver, 170003

Tamila A. Kakhlerova

Tver State Medical University

Email: kahlerova@yandex.ru
Russian Federation, 4, Sovetskaya str., Tver, 170003

References

  1. Grigor'ev EG, Apartsin KA, Belykh GK. Khirurgiya povrezhdenii selezenki. Irkutsk: IGMU; 1996. (In Russ).
  2. Kamalov YR, Sandrikov VA, Bokhyan TS, et al. Ultrasound assessment of normal hepatic vascular diameter and blood flow parameters: methods and values. Angiology and vascular surgery. 1999;5(2):25–41. (In Russ).
  3. Podkamenev VV, Pikalo IA. [Spleen trauma in children]. Khirurgiia (Mosk). 2015(5):40–44. (In Russ). doi: 10.17116/hirurgia2015540-44
  4. Seufert RM. Transplantation of the spleen--status determination. Chirurg. 1986;57(4):182–188.
  5. Pilipenko–Shapkina AP, Sipukhin YM, Moskvichev VG. Zakrytaya travma pecheni i selezenki u detei. Vladivostok; 1987. (In Russ).
  6. Pugachev AG, Finkel'son EI. Zakrytye povrezhdeniya organov bryushnoi polosti u detei. Moscow: Meditsina; 1981. (In Russ).
  7. Tsap NA. Sovershenstvovanie ekstrennoi pomoshchi detyam s travmaticheskimi povrezhdeniyami organov bryushnoi polosti i zabryushinnogo prostranstva [dissertation]. Omsk; 2011. (In Russ).
  8. Shapkin VV, Pilipenko AP, Shapkina AN, et al. Lechebnaya taktika pri zakrytoi travme selezenki u detei. Russian Journal of Pediatric Surgery. 2004;(1):27–31. (In Russ).
  9. Lynn KN, Werder GM, Callaghan RM, et al. Pediatric blunt splenic trauma: a comprehensive review. Pediatr Radiol. 2009;39(9):904–916; quiz 1029–1030. doi: 10.1007/s00247-009-1336-0
  10. Bunatyan AA. Spravochnik po anesteziologii i reanimatologii. Moscow: Meditsina; 1982. (In Russ).
  11. Klimanskii VA, Rudaev YN. Transfuzionnaya terapiya pri khirurgicheskikh zabolevaniyakh. Moscow: Meditsina; 1984. (In Russ).
  12. Malysheva VD. Intensivnaya terapiya. Reanimatsiya. Pervaya pomoshch'. Moscow: Meditsina; 2000. (In Russ).
  13. Dubois JJ, Pokorny WJ. Trauma protocols for evaluation and managemen. In: Management of pediatric trauma. W.B. Saunders Company; 1995. P: 70–89.
  14. Sokolov VV, Kaplunova OA, Ovseenko TE. Vozrastnye osobennosti arkhitektoniki arterial'nykh sosudov selezenki. Original'nye issledovaniya. 2003;124(4):57–59. (In Russ).
  15. Dixon JA, Miller F, McCloskey D, Siddoway J. Anatomy and techniques in segmental splenectomy. Surg Gynecol Obstet. 1980;150(4):516–520.
  16. Garcia-Porrero JA, Lemes A. Arterial segmentation and subsegmentation in the human spleen. Acta Anat (Basel). 1988;131(4):276–283. doi: 10.1159/000146529
  17. Mandarim-Lacerda CA, Sampaio FJ, Passon MA. Segmentation vasculaire de la rate chez le nouveau-ne: support anatomique pour la resection partielle. Journal De Chirurgie (Paris). 1983;120:471.
  18. Podkamenev VV, Pikalo IA, Zaĭtsev AP. The risk of death from splenic ruptures by polytrauma among children. Pirogov Russian Journal of Surgery. 2013;(3):61–65. (In Russ).
  19. Dubrov EY, Chervonenkis AV. Ul'trazvukovaya diagnostika krovotechenii zabryushinnykh gematom. Pirogov Russian Journal of Surgery. 1978;(12):77–80. (In Russ).
  20. Goodman LR, Aprahamian C. Changes in splenic size after abdominal trauma. Radiology. 1990;176(3):629–632. doi: 10.1148/radiology.176.3.2389017
  21. Shiller M. The spleen. Journal of Pediatric Surgery. 1998;(2):1545–1554.
  22. Rozinov VM, Savel'ev SB, Belyaeva OA, Burkin IA. Diagnostika i lechenie chrezkapsulyarnykh povrezhdenii selezenki u detei s politravmoi. In: Tezisy dokladov vserossiiskogo simpoziuma detskikh khirurgov “Politravma detei”. Samara; 2001:92–93. (In Russ).
  23. Arrillaga A, Graham R, York JW, Miller RS. Increased efficiency and cost-effectiveness in the evaluation of the blunt abdominal trauma patient with the use of ultrasound. Am Surg. 1999;65(1):31–35.
  24. Asher WM, Parvin S, Virgillo RW, Haber K. Echographic evaluation of splenic injury after blunt trauma. Radiology. 1976;118(2):411–415. doi: 10.1148/118.2.411
  25. Elabbassi-Skalli A, Ouzidane L, Maani K, et al. [Abdominal injuries in children. The value of emergency abdominal ultrasonography]. Arch Pediatr. 1998;5(3):269–273. doi: 10.1016/s0929-693x(97)89367-0
  26. Siniluoto TM, Paivansalo MJ, Lanning FP, et al. Ultrasonography in traumatic splenic rupture. Clin Radiol. 1992;46(6):391–396. doi: 10.1016/s0009-9260(05)80685-3
  27. Abakumov MM, Lebedev NV, Malyarchuk VI. Diagnostika i lechenie povrezhdenii zhivota. Pirogov Russian Journal of Surgery. 2001;(6):24–28. (In Russ).
  28. Abakumov MM, Dubrov EY, Vladimirova ES, et al. Ul’trazvukovye metody issledovaniya v opredelenii lechebnoi taktiki u postradavshikh s povrezhdeniem selezenki. Pirogov Russian Journal of Surgery. 2001;(8):21–24. (In Russ).
  29. Maskin SS, Ermolaeva NK. Ultrasonic diagnostics of closed traumas of organs of. Grekov's bulletin of surgery. 2007:166(6);96–100. (In Russ).
  30. Ermolaeva NK. Vybor taktiki lecheniya zakrytykh travm zhivota i zabryushinnogo prostranstva po ul'trasonograficheskim dannym [dissertation]. Volgograd; 2004. (In Russ).
  31. Shackford SR, Molin M. Management of splenic injuries. Surg Clin North Am. 1990;70(3):595–620. doi: 10.1016/s0039-6109(16)45132-7
  32. Rathaus V, Zissin R, Werner M, et al. Minimal pelvic fluid in blunt abdominal trauma in children: the significance of this sonographic finding. J Pediatr Surg. 2001;36(9):1387–1389. doi: 10.1053/jpsu.2001.26377
  33. Molitvoslovov AB, Bokeriya MI, Mamontov VK, et al. Diagnostika povrezhdenii zhivota pri sochetannoi travme. Pirogov Russian Journal of Surgery. 2002;(9):22–26. (In Russ).
  34. Rodyanov VM, Savel'ev SB. Ekhografiya v diagnostike povrezhdenii vnutrennikh organov u detei s zakrytoi travmoi zhivota. Pirogov Russian Journal of Surgery. 1989;65(7):80–81. (In Russ).
  35. Sirlin CB, Casola G, Brown MA, et al. Patterns of fluid accumulation on screening ultrasonography for blunt abdominal trauma: comparison with site of injury. J Ultrasound Med. 2001;20(4):351–357. doi: 10.7863/jum.2001.20.4.351
  36. Dubrov EY. Ul'trazvukovaya diagnostika zakrytoi travmy zhivota u bol'nykh s politravmoi. In: 1-i s’ezd assotsiatsii spetsialistov ul'trazvukovoi diagnostiki v meditsine: tezisy dokladov. Moscow; 1991. P:133–132. (In Russ).
  37. Dubrov EY, Chervonenkis AV. Ul'trazvukovaya diagnostika krovotechenii v bryushnuyu polost'. Pirogov Russian Journal of Surgery. 1977;53(1):89–93. (In Russ).
  38. Kirillov SV. Ul'trazvukovoe issledovanie v diagnostike i lechenii zakrytykh sochetannykh povrezhdenii pochek. In: 3-i s"ezd Rossiiskoi assotsiatsii spetsialistov ul'trazvukovoi diagnostiki v meditsine: tezisy dokladov. Moscow; 1999. P:120–121. (In Russ).
  39. Belyaeva OA, Rozinov VM. Vozmozhnosti ekhografii v detskoi khirurgii. In: Ekhografiya vnutrennikh organov u detei pod redaktsiei Dvoryakovskogo IV. Moscow; 1994:393–396. (In Russ).
  40. Ol’khova YR, Bykovskii VA, Romanov DV. Znachenie kompleksnogo ul’trazvukovogo issledovaniya v diagnostike travmaticheskikh povrezhdenii u detei rannego vozrasta: klinicheskoe nablyudenie i obzor literatury. Ekhografiya. 2001;(1):54–60. (In Russ).
  41. Baklanov VV, Volkov IE, Safronov BG, Burov IS. Znachenie laparoskopii pri vybore taktiki lecheniya travmaticheskikh povrezhdenii selezenki u detei. In: Materialy simpoziuma "Endoskopicheskaya khirurgiya u detei". Ufa; 2002. P:16–18. (In Russ).
  42. Bastrygin AV, Zhila NG, Shapkin VV, et al. Diagnostika i lechebnaya taktika pri travmaticheskikh povrezhdeniyakh selezenki u detei. Khabarovsk: Izdatel’stvo DVGMU; 2009. (In Russ).
  43. Kotlyarov AN, Imamov MZ, Rostovtsev NM, et al. Laparoskopiya v diagnostike i lechenii zakrytykh povrezhdenii organov bryushnoi polosti u detei. In: Tezisy dokladov Vserossiiskogo simpoziuma detskikh khirurgov “Politravma detei”. Samara; 2001. P:56–57. (In Russ).
  44. Shapkin YG, Kirichuk VF, Maslyakov VV. Izmeneniya pokazatelei beloi krovi u detei, operirovannykh pri travme selezenki, v zavisimosti ot vida perenesennoi operatsii. Russian Journal of Pediatric Surgery. 2010;(1):19–22. (In Russ).
  45. Upadhyaya P. Conservative management of splenic trauma: history and current trends. Pediatr Surg Int. 2003;19(9–10):617–627. doi: 10.1007/s00383-003-0972-y
  46. Klimanskii VA. Splenektomiya. In: Bol'shaya meditsinskaya entsiklopediya pod redaktsiei B.V. Petrovskogo. Tom 14. Moscow; 1985:144–145.
  47. Safronov EP, Kovalenko SI, Shkurenkov NV, Shestopalova LM. Rol' organosokhranyayushchikh operatsii na selezenke pri sochetannoi travme. In: Aktual'nye voprosy neotlozhnoi spetsializirovannoi pomoshchi v gorodskoi klinicheskoi bol'nitse Moskvy. Moscow; 2001. P:134–137. (In Russ).
  48. Mooney DP. Multiple trauma: liver and spleen injury. Curr Opin Pediatr. 2002;14(4):482–485. doi: 10.1097/00008480-200208000-00021
  49. Toutouzas KG, Velmahos GC, Kaminski A, et al. Leukocytosis after posttraumatic splenectomy: a physiologic event or sign of sepsis? Arch Surg. 2002;137(8):924–928; discussion 928–929. doi: 10.1001/archsurg.137.8.924
  50. Tsugawa K, Koyanagi N, Hashizume M, et al. New insight for management of blunt splenic trauma: significant differences between young and elderly. Hepatogastroenterology. 2002;49(46):1144–1149.
  51. Karagyulyan SR, Grzhimolovskii AV, Danishyan KI, et al. Surgical accesses to spleen. Annals of hpb surgery. 2006;11(2):92–99. (In Russ).
  52. Ostroverkhov GE, Lubotskii DN, Bomash YM. Kurs operativnoi khirurgii i topograficheskoi anatomii. Moscow: Medgiz; 1963. (In Russ).
  53. Delaitre B, Maignien B. [Splenectomy by the laparoscopic approach. Report of a case]. Presse Med. 1991;20(44):2263.
  54. Dronov AF, Poddubnyi VI, Smirnov AN, et al. Laparoskopicheskaya splenektomiya pri vrozhdennoi gemoliticheskoi anemii u detei. Pirogov Russian Journal of Surgery. 2002;(11):14–18. (In Russ).
  55. Dronov AF, Poddubnyi IV, Kotlobovskii VI, Zalikhin DV. Laparoskopicheskaya khirurgiya pri patologii selezenki u detei. Endoscopic surgery. 1998;4(4):18–22. (In Russ).
  56. Kotlobovskii VI, Dronov AF, Narmukhamedov ZhK, et al. Sluchai uspeshnogo vypolneniya laparoskopicheskoi splenektomii u rebenka. In: 1-i Mezhdunarodnyi kongress endoskopicheskoi khirurgii. Moscow; 1995. P:66–67. (In Russ).
  57. Beanes S, Emil S, Kosi M, et al. A comparison of laparoscopic versus open splenectomy in children. Am Surg. 1995;61(10): 908–910.
  58. Curran TJ, Foley MI, Swanstrom LL, Campbell TJ. Laparoscopy improves outcomes for pediatric splenectomy. J Pediatr Surg. 1998;33(10):1498–1500. doi: 10.1016/s0022-3468(98)90484-5
  59. Esposito C, Corcione F, Ascione G, et al. Splenectomy in childhood. The laparoscopic approach. Surg Endosc. 1998;12(12):1445–1448. doi: 10.1007/s004649900879
  60. Janu PG, Rogers DA, Lobe TE. A comparison of laparoscopic and traditional open splenectomy in childhood. J Pediatr Surg. 1996;31(1):109–113; discussion 113–104. doi: 10.1016/s0022-3468(96)90330-9

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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