Supplemental Digital Content 1. Demographics, Clinical Information, Indications for Surgery, and Blood Product Utilization Among the 10
Pediatric Patients Requiring Splenectomy (5/2008 - 5/2012)
Age and
gender
ISS
Major injuries
Preop location &
procedures
Indication for surgery
Operative
course
Postoperative
course
Blood
product
utilization
2U prior to
arrival
0U preop
3U OR
0U postop
LOS
17 yo F
29
Gr III splenic laceration
Renal laceration
Subgaleal hematoma
Hemoperitoneum
History of hereditary
spherocytosis
ICU
New tachycardia;
HCT 18
EBL 2L
Splenectomy
Uncomplicated
11 yo M
50
Gr V splenic laceration
GR V renal laceration
Diaphragm rupture
Hemothorax
Complex femur fracture
ED , s/p chest
tube, intubation
Hypotension (BP
90/60),
DPL +
HCT 27  22 after
hemothorax drained
EBL 2L
Splenectomy,
nephrectomy,
diaphragm
repair
Postoperative HCT
33  21, not
transfused.
Otherwise
uncomplicated.
2U ED
5U OR
0U postop
9
16 yo M
41
ICU, s/p pelvic
fixation
HCT 21  17
following 8.5L IVF,
pelvic fixation
12 yo F
36
Gr IV splenic laceration
Pelvic fracture
Dislocated femur
Multiple extremity
fractures
Gr V splenic laceration
Gr IV liver laceration
Gr III renal laceration
Hemothorax
Lung laceration
EBL 0.9 L
Splenectomy
Postoperative HCT
16, transfused.
Multiple orthopedic
procedures.
0U preop
3U intraop
2U postop
26
ICU, s/p chest
tube
Hypotension,
tachycardia
EBL 0.9 L
Splenectomy,
liver packing
0U preop
3U intraop
0U postop
22
ED, s/p chest
tube
+ DPL, hypotension,
HCT 28  25 despite
PRBC, with EBL 0.9L
after chest tubes
EBL 1L
Splenectomy
Postoperative HCT
32  23, not
transfused. Return
to OR for abdominal
closure. Prolonged
pulmonary recovery.
Postoperative HCT
30  23.
Subsequent pelvic
fixation.
17 yo M
57
Gr IV splenic laceration
Renal laceration
Hemothorax
Flail chest
Pelvic fracture
Intracranial hemorrhage
2U preop
4U intraop
0U postop
26
15 yo M
57
Gr IV splenic laceration
Gr III renal laceration
Hemoperitoneum
Epidural hematoma
ED
Refractory
hypotension, DPL +,
initial HCT 16
EBL 2.5 L
Splenectomy,
renal repair
Postoperative
hematocrit 27  19.
Subsequent
decompressive
2U preop
7U intraop
7U postop
16
8
Pneumothorax
Pulmonary contusion
Bowel ischemia
craniotomy.
16 yo F
41
Gr IV splenic laceration
Pelvic fracture
Pulmonary contusions
Pneumothorax
Severe TBI
ED
Tachycardia, HCT 31
 21
EBL 0.25L
Splenectomy,
pelvic fixation
Uneventful
1U preop
0U intraop
0U postop
7
17 yo M
20
GSW to chest, abdomen
Gr IV splenic laceration
Liver laceration
Stomach laceration
Pancreatic laceration
Diaphragm rupture
Pneumothorax
ED > chest tube
Exploration for
penetrating
abdominal injury
EBL 1.9L
Splenectomy,
liver packing
Subsequent
pancreatic
debridement,
diagphragm repair
1U prior to
transfer
1U preop
4U intraop
0U postop
29
17 yo M
41
Gr III splenic laceration
Open femur fracture
Pelvic fracture
L iliac rupture
Sternal fracture
ED
Hypotension,
tachycardia despite
resuscitation.
EBL 0.9L. HCT
31 23
intraoperatively.
Splenectomy
Postoperative HCT
32  22, return to
OR for femur
fracture, pelvic
stabilization
3U preop
2U intraop
5U postop
17
15 yo M
34
Gr IV splenic laceration
Renal laceration
Femur fracture
ED
Tachycardia, HCT 34
 26 from
transferring hospital,
FAST +
EBL 1.5L.
Splenectomy
Postoperative HCT
33 19, return to
OR for femur
fracture
1U preop
2U intraop
1U postop
7