Splenic and hepatic trauma in children.

The concepts for proper management of splenic and hepatic injuries have been evolving over the last several years. The recognition that aggressive surgical therapy in some instances was responsible for the number of life-threatening complications led to a reappraisal of the principles of care for these traumatic lesions. The emerging consensus of opinion is that often nonoperative therapy or more "conservative" operations are preferable. The accumulated experience to date supports the view that this more selective therapeutic approach will result in lower morbidity and mortality for children sustaining splenic or hepatic injuries. Fortunately, the recent technologic improvements in the field of radiology have enabled the clinician to diagnose and serially evaluate these major intra-abdominal injuries with a high degree of confidence.