Observation of splenic trauma: When is a little too much?

A 12-year-old boy was treated conservatively for a grade II splenic lacerat ion. On discharge, he was instructed to avoid contact sports, running, and strenuous physical activity. Thirty-eight days later, after diving off the side of a swimming pool, he had abdominal pain, nausea, and diaphoresis. On admission, he was hemodynamically unstable. Results of a diagnostic ravage showed gross blood. At laparotomy, a fractured spleen was found, and splen ectomy was performed. He recovered without complication. This case question s the activity restrictions placed on patients with conservatively managed splenic trauma. Avoidance of only contact sports and heavy exertion may be inadequate. J Pediatr Surg 34:1124-1126. Copyright (C) 1999 by W.B. Saunder s Company.