• Main page
• About the journal
• Editorial board
• Subscription
• Information for contributors
• Editorial and Peer Review
• Issues archive
• Authors
• Articles
  • By alphabet
  • By category
• Blogs and comments

The journal is included into The list of leading scientific periodicals.

The journal is included into VINITI database and is registered in Electronic scientific library.

The journal is indexed by SCOPUS, Ulrich's International Periodicals Directory.

EBSCO

https://doi.org/10.14300/mnnc.2016.11090

Concept of spontaneous hemostasis in trauma spleen in children

[Surgery]
Vladimir Podkamenev; Ilya Pikalo;

The article explains the concept of early spontaneous hemostasis in transcapsular spleen injuries in children and the possibility of non-operative treatment.
We carried out a retrospective study of 105 children who died of associated injuries and a prospective study of 75 children with splenic injury, of which 69 (92%) children were treated non-operative. Spleen injury was detected in 33 (31.4%) patients. The risk of death at the scene was very low (OR = 0.09; p<0.017) and is associated exclusively with a separation of the organ from the vessel. Thanatogenic feature of spleen injury in childhood is the prevalence of moderate blood loss and a very low risk of death from hemorrhagic shock due
to massive blood loss. Surgical treatment was performed in 6 (8%) of children due to the ongoing intraperitoneal bleeding. In the group of patients with non-operational treatment moderate degree of blood loss was observed, which did not exceed 15% of blood volume. Spontaneous hemostasis can be considered as a defense mechanism, based on anatomical and physiological characteristics of the spleen in children. Spontaneous hemostasis is one of the parts of pathogenesis of the spleen closed injuries in children and an argument in favor of non-operative treatment.

Download

References:
1. Аverin V., Katko V., Svirskij A., Makhlin A. Vrach. – Doctor. 1996;1:15.
2. Bastryigin A. V., Zhila N. G., Shapkin V. V., Shapkina A. N. Diagnostika i lechebnaya taktika pri travmaticheskih povrezhdeniyah selezenki u detey. Habarovsk; 2009. 189 p.
3. Apartsin K. A., Lepekhova S. A., Galejev Yu. M., Prokopiev M. V., Grigoriev S. E. Mehanizmyi razvitiya postsplenektomicheskih rasstroystv gomeostaza. Neoperativnoe lechenie povrezhdeniy selezenki u detey. V. V. Podkamenev, K. A. Apartsin, E. G. Grigoriev. Novosibirsk: «Nauka»; 2014. P. 64-74.
4. Beliajeva O. A., Rozinov V. M., Beliajeva A. V., Savelyev S. B. Ehograficheskaya diagnostika povrezhdeniy selezenki. Neoperativnoe lechenie povrezhdeniy selezenki u detey. V. V. Podkamenev, K. A. Apartsin, E. G. Grigoriev. Novosibirsk: «Nauka»; 2014; P.131-148.
5. Geller L. I. Fiziologiya i patologiya selezenki. M. : «Meditsina »; 1964. 162 p.
6. Doskin V. A., Keller K. H., Muraenko M. N., Tonkova-Yampolskaya R. V. Morfofunktsionalnye konstanty detskogo organizma. M. : «Meditsina»; 1997. 288 p.
7. Zhurilo I. P., Mishakov S. V., Grona V. N., Lepihov P. A., Moskalenko S. V. Zdorove rebenka. – Child health. 2013;4(47):114-118.
8. Komissarov I. A., Filippov D. V., Yalfimov A. N., Denisov A. A. Detskaya khirurgiya. – Pediatric Surgery. 2009;6:7-13.
9. Podkamenev V. V., Pikalo I. A. Detskaya hirurgiya. – Pediatric Surgery. 2015;1:24-27.
10. Rozinov V. M., Savelev S. B., Belyaeva O. A., Burkin I. A. Diagnostika i lechenie chreskapsulnykh povrezhdenij selezenki u detej s politravmoj. Materialy Vserossijskogo simpoziuma detskikh khirurgov. Politravma u detej. Samara; 2001. Р. 92-93.
11. Sokolov V. V., Kaplunova O. А., Ovseenko T. E. Originalnye issledovaniya. – Original research. 2003;124(4): 57-59.
12. Tsap N. А. Sovershenstvovanie ehkstrennoj pomoshhi detyam s travmaticheskimi povrezhdeniyami organov bryushnoj polosti i zabryushinnogo prostranstva: avtoref. diss… d-ra med. nauk. Omsk; 2011. 48 p.
13. Bairdain S., Litman H. J., Troy M., McMahon M., Almodovar H., Zurakowski D., Mooney D. P. J. Pediatr. Surg. 2015;50(5):864-868.
14. Buntain W. L. Management of pediatric trauma. – Philadelphia: W. B. Saunders Company; 1995. 814 p.
15. Dixon J. A., Miller F., McCloskey D., Siddoway J. Surg. Gynecol. Obstet. 1980;150:516.
16. Dobremez E., Lefevre Y., Harper L. J. Pediatr. Surg. 2006;16:166-170.
17. Garcia-Porrero J. A., Lemes A. Acta Anat. 1988;131:276- 283.
18. Goodman L. R., Aprahamian C. Radiology. 1990;176(3):629-632.
19. Mandarim-Lacerda C. A., Sampaio F. J., Passos M. A. J. Chir. (Paris). 1983;120:471.
20. Moore E. E., Cogbill T. H., Jurkovich G. L. J. Trauma. 1995;38:323-324.
21. Peter S. D., Sharp S. W., Snyder C. L. J. Pediatr. Surg. 2011;46:173-177.
22. Shiller M. The spleen. Pediatric surgery. 5 th ed. J. A. O’Neill. – St Louis: Mosby Press, 1998;2:1545-1554.
23. Tepas J. S. Triage, trauma score, and transport. Management of pediatric trauma. W. L. Buntain. Philadelphia: W. B. Saunders Company; 1995. Р. 57-69.
24. Upadhyaya P., Simpson J. S. Surg. Gynecol. Obstet. 1968;126:781-790.
25. Upadhyaya P. Pediatr. Surg. Int. 2003;19:617-627.

Keywords: trauma of spleen, children, non-surgical treatment, spontaneous hemostasis