Introduction This article assesses (1) access to splenic embolization (SE), (2) indications for SE, and (3) post-embolization management in high-grade splenic trauma in children.

Materials and Methods An online questionnaire was sent in 2021 to all members of European Pediatric Surgeons' Association.

Results There were a total of 157 responses (50 countries, 83% academic hospitals). Among them, 68% have access to SE (SE) and 32% do not (nSE). For a hemodynamic stable patient with high-grade isolated splenic trauma without contrast extravasation (CE) on computed tomography (CT) scan, 99% SE and 95% nSE respondents use nonoperative management (NOM). In cases with CE, NOM decreases to 50% (p = 0.01) and 51% (p = 0.007) in SE and nSE centers, respectively. SE respondents report a significant reduction of NOM in stable patients with an associated spine injury requiring urgent surgery in prone position, both without and with CE (90 and 28%, respectively). For these respondents, in stable patients the association of a femur fracture only tends to decrease the NOM, both without and with CE (93 and 39%, respectively). There was no significant difference in NOM in group nSE with associated injuries with or without CE. After proximal SE with preserved spleen vascularization on ultrasound Doppler, 44% respondents prescribe antibiotics and/or immunizations.

Conclusion Two-thirds of respondents have access to SE. For SE respondents, SE is used even in stable patients when CE showed on initial CT scan and its use increased with the concomitant need for spinal surgery. There is currently a variation in the use of SE and antibiotics/immunizations following SE.

简介 本文评估 (1) 脾栓塞 (SE) 的可及性，(2) SE 的适应症，以及 (3) 儿童重度脾外伤的栓塞后管理。

材料和方法 2021 年向欧洲儿科外科医生协会的所有成员发送了一份在线问卷。

结果 共有 157 份回复（50 个国家，83% 的学术医院）。其中，68% 的人可以访问 SE（SE），32% 的人不能（nSE）。对于在计算机断层扫描 (CT) 扫描中没有造影剂外渗 (CE) 的高度孤立性脾脏损伤的血流动力学稳定患者，99% SE 和 95% nSE 受访者使用非手术治疗 (NOM)。在使用 CE 的情况下，NOM 降低到 50% ( p  = 0.01) 和 51% ( p = 0.007) 分别位于 SE 和 nSE 中心。SE 受访者报告说，在没有和有 CE 的情况下，伴有相关脊柱损伤需要俯卧位紧急手术的稳定患者的 NOM 显着减少（分别为 90 和 28%）。对于这些受访者，在稳定的患者中，股骨骨折的关联只会降低 NOM，无论是没有 CE 还是有 CE（分别为 93 和 39%）。nSE 合并损伤伴或不伴 CE 组的 NOM 无显着差异。在超声多普勒显示脾血管化保留的近端 SE 后，44% 的受访者开了抗生素和/或免疫接种。

结论 三分之二的受访者可以访问 SE。对于 SE 受访者，当 CE 在初始 CT 扫描中显示时，甚至在稳定的患者中也会使用 SE，并且随着伴随的脊柱手术需要，SE 的使用增加。目前，SE 的使用和 SE 后的抗生素/免疫接种存在差异。