SPLENIC INJURY FROM BLUNT ABDOMINAL-TRAUMA IN CHILDREN - FOLLOW-UP EVALUATION WITH CT

PURPOSE: To assess if the initial grade of splenic injury depicted at computed tomography (CT) in children could help predict rate of healing. MATERIALS AND METHODS: Thirty-seven children with splenic injury graded at emergent CT were prospectively followed up with nonenhanced and contrast material-enhanced CT performed 2 weeks to 11 months after injury. RESULTS: In all 15 grade 1 and 2 splenic injuries, healing was seen at follow-up, including eight injuries that occurred in patients who underwent follow-up CT within 4 months. In 10 of 11 grade 3 splenic injuries, healing was seen within 6 months. In all 11 grade 4 injuries, residual lesions were seen within 4 months and healing took up to 11 months. Five of nine residual splenic injuries were more clearly visualized with contrast material enhancement, No splenic complications occurred. CONCLUSION: CT grade of splenic injury is related to rate of healing. Grade 1 and 2 injuries typically heal within 4 months, whereas grade 3 injuries take up to 6 months to heal and grade 4 injuries take up to 11 months.