Splenic Rupture in Children With Portal Hypertension

Journal of Pediatric Gastroenterology and Nutrition
Orith Waisbourd-ZinmanElizabeth B Rand

Abstract

Massive splenomegaly from portal hypertension (PHTN) in children raises the specter of splenic rupture; however, the incidence, etiology, and risk of rupture have not been studied, nor have existing practices to reduce risk. We therefore performed an international survey to describe the splenic rupture cases in PHTN and to describe the existing empirical practice among hepatologists. A questionnaire was constructed to elicit cases of splenic rupture and collect hepatologists' common practices for prevention of splenic rupture. Pediatric hepatologists working in selected tertiary academic centers in the United States, Canada, and the United Kingdom were contacted. Hepatologists from 30 of 35 centers who met the inclusion criteria replied to the survey. Thirteen cases of splenic rupture were described of which 11 resulted from trauma. In the opinion of the practitioners, high-risk activities were football, hockey, and wrestling. Sixty-one percent recommended total restriction from high-risk activities. Seventy-four percent stated that platelet count had no effect on this decision and 61% advised a spleen guard for certain activities. Splenic rupture in patients with PHTN and splenomegaly seems to be rare. The reported splenic rup...Continue Reading

References

Jan 11, 2008·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Nirtal Shah, Doug Richards
Mar 1, 2008·Current Sports Medicine Reports·John Turner, Meena Garg
Dec 12, 2012·Pediatric Emergency Care·Andrea S Rinderknecht, Wendy J Pomerantz

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