Splenorraphy for the treatment of splenic rupture in infants and children.

An 18-month-old black male child who had a successful hepatorraphy and splenorraphy for lacerations of each organ secondary to a six story fall is presented. Splenectomy has been performed in the past 50 years for essentially all splenic trauma. Recent reports have indicated the important role of the spleen in the immunologic defense mechanism, especially in the infant and child. The significance of the loss of the phagocytic activity and antibody response mechanisms iwth an asplenic infant or child are appreciated when one considers the increased morbidity and mortality rates in these asplenic patients. If one further studies the anatomic configuration of the spleen in the infant and child, one may repair a laceration of the spleen successfully in the laboratory as well as in the clinical situation. Although not advocated at this time for general use, a selective approach should be considered for the use of splenorraphy instead of splenectomy in traumatic lacerations of the spleen.