Preserved function after angioembolisation of splenic injury in children and adolescents: a case control study

Autor: Thomas Larsen Titze, Christine Gaarder, Paal Aksel Naess, Anne Grete Bechensteen, Ruth Jeanette Vaaler Loekke, Ingeborg S. Aaberge, Liv T. N. Osnes, Hans Erik Heier, Jorunn Skattum
Rok vydání: 2012
Předmět:
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
T-Lymphocytes
Splenectomy
Physical examination
Spleen
Enzyme-Linked Immunosorbent Assay
Abdominal Injuries
Splenic artery
Wounds
Nonpenetrating
Gastroenterology
Overwhelming post-splenectomy infection
Clinical Protocols
medicine.artery
Internal medicine
parasitic diseases
medicine
Humans
Medical history
Embolization
Child
General Environmental Science
Retrospective Studies
Ultrasonography
B-Lymphocytes
medicine.diagnostic_test
business.industry
Retrospective cohort study
medicine.disease
Flow Cytometry
Embolization
Therapeutic
Surgery
Immunoglobulin A
medicine.anatomical_structure
Treatment Outcome
Immunoglobulin M
Case-Control Studies
Immunoglobulin G
General Earth and Planetary Sciences
Female
Immunization
business
Splenic Artery
Follow-Up Studies
Zdroj: Injury. 45(1)
ISSN: 1879-0267
Popis: Background Non-operative management for blunt splenic injuries was introduced to reduce the risk of overwhelming post splenectomy infection in children. To increase splenic preservation rates, splenic artery embolization (SAE) was added to our institutional treatment protocol in 2002. In the presence of clinical signs of ongoing bleeding, SAE was considered also in children. To our knowledge, the long term splenic function after SAE performed in the paediatric population has not been evaluated and constitutes the aim of the present study. Methods A total of 11 SAE patients less than 17 years of age at the time of injury were included with 11 healthy volunteers serving as matched controls. Clinical examination, medical history, general blood counts, immunoglobulin quantifications and flowcytometric analysis of lymphocyte phenotypes were performed. Peripheral blood smears were examined for Howell–Jolly bodies (H–J bodies) and abdominal ultrasound was performed in order to assess the size and perfusion of the spleen. Results On average 4.6 years after SAE (range 1–8 years), no significant differences could be detected between the SAE patients and their controls. Total and Pneumococcus serospecific immunoglobulins and H–J bodies did not differ between the study groups, nor did general blood counts and lymphocyte numbers, including memory B cell proportions. The ultrasound examinations revealed normal sized and well perfused spleens in the SAE patients when compared to their controls. Conclusion This case control study indicates preserved splenic function after SAE for splenic injury in children. Mandatory immunization to prevent severe infections does not seem warranted.
Databáze: OpenAIRE
Externí odkaz: