Management of blunt hepatic and splenic trauma in children.

Trauma is a major cause of morbidity and mortality in children. With blunt abdominal trauma, the most commonly injured organs are the liver and the spleen.1 Th e management of blunt hepatic and splenic injuries has evolved over the past three decades from an emergency operation to a nonoperative approach. Th e nonoperative management of splenic injuries in children became acceptable because of the signifi cant incidence and seriousness of postsplenectomy sepsis, and the frequent complications associated with non-therapeutic laparotomies.2 Subsequently, nonoperative management of hepatic injuries showed similar success to the results of splenic injuries.3,4 Th us, in the hemodynamically stable child, nonoperative management of hepatic and/or splenic injuries has become the current standard of care. However, in the hemodynamically unstable child or the child with signs or symptoms of peritonitis, an immediate operation is necessary. Th is report is a retrospective review of children with blunt hepatic and/ or splenic injuries managed at King Fahad National Guard Hospital, Riyadh, Saudi Arabia.