Current management of iatrogenic splenic injuries in children

Recent clinical observations indicate that children who have undergone splenectomy for trauma have a significantly increased incidence (about 2 per cent) of subsequent fatal sepsis, particularly with pneumococcus organisms. Some protection against fatal sepsis may be afforded by immunization with the newly developed pneumococcal vaccine in children more than 2 years old or by the use of prophylactic penicillin. However, splenectomy should be avoided whenever possible. The vast majority of iatrogenic splenic injuries that occur during renal operations in children are usually minor capsular lacerations that can be managed conservatively, using suturing techniques and drainage, and do not require splenectomy.