Fractured Spleen & Splenic Infarction in Teens: Symptoms, Diagnosis & Understanding

Question
Our 13-year old daughter was recently diagnosed with a fractured spleen or splenic infarct.
Her initial symptoms were nausea and vomiting, abdominal pain, and fatigue. She was hospitalized for 4 days, has had blood tests, and 2 CT scans, which showed abdominal fluid and part of the spleen which was not receiving blood flow.The physicians were unable to really explain what was going on with her spleen.  She tested positive for a past EBV infection which was never noticed by us or my daughter. Her platelet count is slightly over 1,000,000. Our surgeon has recommended that we wait and have her blood and CT scan retested in a month to see if the platelet count has come down. She is back to school, and receiving  medication for pain as needed. My question is: are we being aggressive enough? How long does it take for a platelet count to return to normal after mono or a spleen injury. (My daughter has no recollection of a significant injury to her abdomen.}She is still fatigued and has a moderate level of constant pain. Any advice is much appreciated. Thank you. Cheri Metts  

Answer
dear ms metts:
if the diagnosis of ebv is secure and the blood smear - except for the thrombocytosis is normal - an expectant attitude is certainly warranted. formerly, in cases of splenic rupture the spleen was removed. surgeons have become more conservative and this is good for the patients since keeping her spleen may avoid future infectious complications in your daughter.
wishing her a speedy recovery i remain with my best regards
swissdoc