Management of Splenic Vascular Anomalies: A Review of 17 Pediatric Cases at a Single Institution

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2025-02-25 DOI:10.1016/j.jpedsurg.2025.162254

Josephine L. Schmidt , Michael B. Gyimah , Bea B. Jeon , Amir H. Pezeshkmehr , Alex Chau , Ionela Iacobas , Kristy L. Rialon

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引用次数: 0

Abstract

Background

Splenic Vascular Anomalies (SVA) are rare splenic masses seen in the pediatric population. There is limited information regarding the management and appropriate follow-up for these patients. The aim of this study was to review our experience and create an algorithm to help guide clinical care.

Methods

A retrospective review of pediatric patients diagnosed with SVA from 2011 to 2024 was performed. Clinical history and outcomes data were summarized descriptively. A Mann–Whitney U test was performed to compare SVA diameters between surgical and nonsurgical groups.

Results

Seventeen patients met inclusion criteria for this study. SVA was identified incidentally in 15 patients (88 %). The median maximal SVA diameter was 5.2 cm (range: 5–7 cm) for the six surgical patients and 3.6 cm (range: 1–5.7 cm) for the 11 nonsurgical patients (p = 0.009). Five patients (83 %) underwent total splenectomy, and one patient (17 %) underwent partial splenectomy. Indications for splenectomy included persistent abdominal pain, large size on imaging, and concern for splenic rupture. Preoperative imaging correlated with postoperative pathology in 4/6 (66 %) surgical patients. Among all patients, the median number of days between the first imaging study to identify the SVA and the last study monitoring the SVA was 632 days (range: 0–2337 days). The median change in SVA maximal diameter during that time was 0.05 cm (range: −1.6 – 0.9 cm).

Conclusion

SVA can be monitored with serial imaging and do not undergo rapid growth. Most operative interventions are performed based on SVA size (>5 cm) and rarely on symptoms.

Level of evidence

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脾脏血管异常的处理：对同一医院17例儿科病例的回顾

背景：脾血管异常（SVA）是小儿罕见的脾肿物。关于这些患者的管理和适当随访的信息有限。这项研究的目的是回顾我们的经验，并创建一个算法来帮助指导临床护理。方法回顾性分析2011 ~ 2024年诊断为SVA的儿童患者。描述性地总结临床病史和结局数据。采用Mann-Whitney U检验比较手术组和非手术组的SVA直径。结果17例患者符合本研究的纳入标准。15例（88%）患者偶然发现SVA。6例手术患者中位最大SVA直径为5.2 cm（范围：5-7 cm）， 11例非手术患者中位最大SVA直径为3.6 cm（范围：1-5.7 cm）（p = 0.009）。5例（83%）患者行全脾切除术，1例（17%）患者行部分脾切除术。脾切除术的指征包括持续腹痛、影像显示肿大及担心脾破裂。4/6（66%）手术患者术前影像学与术后病理相关。在所有患者中，第一次影像学检查确定SVA和最后一次影像学检查监测SVA之间的中位数天数为632天（范围：0-2337天）。在此期间，SVA最大直径的中位数变化为0.05 cm（范围：−1.6 - 0.9 cm）。结论sva可通过序列显像监测，且无快速生长。大多数手术干预是根据SVA大小（约5cm）进行的，很少根据症状进行。证据水平4。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.