The World Society of Emergency Surgery has given guidance for the management of a pediatric patient with splenic trauma.

Patient selection: pediatric patient with splenic trauma


Indications for laparotomy:

(1) hemodynamic instability

(2) transient responder to immediate resuscitation

(3) bowel evisceration

(4) impalement

(5) peritonitis

(6) other indications for laparotomy (positive FAST, other)

(7) ineffective angioembolization


Indications for angiography:

(1) WSES grade I, II or III on non-operative management with signs of ongoing bleeding


Indications for angioembolization:

(1) positive blush on contrast enhanced CT scan


Non-operative management (NOM) is indicated at a center with sufficient expertise:

(1) WSES Grade I, II or III

(2) after effective angioembolization

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