Blunt Trauma in Pediatric Patients- Experience from Small Center

Djordjević, Ivona; Slavkovic, Andjelka; Marjanović, Zoran; Živanović, Dragoljub

doi:10.7727/wimj.2014.069

Cited by 9 publications

(11 citation statements)

References 18 publications

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“…6 Our study revealed that the school going children (average age 7.05±3.9) were more vulnerable to BSI thus affirming the findings of Djordjevic et al who found that the maximum number of patients with abdominal trauma were seen in age group of 6-10 years. 9 The mean grade of splenic injury was 2.5, close to the grades reported by other authors. 10,11 Nevertheless, the grades of the injuries depend upon the mode and severity of the impact that a patient receives.…”

Section: Discussionsupporting

confidence: 87%

“…8 The male to female ratio was 3.2:1 which is comparable to the observations made by other studies. 9 Male children are more likely to have traumatic injuries especially younger males with lack of parental supervision. 6 Our study revealed that the school going children (average age 7.05±3.9) were more vulnerable to BSI thus affirming the findings of Djordjevic et al who found that the maximum number of patients with abdominal trauma were seen in age group of 6-10 years.…”

Section: Discussionmentioning

confidence: 99%

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Application of non-operative management protocol in pediatric blunt splenic injuries with other associated injuries

et al. 2019

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Background: Non-operative management (NOM) has become the standard of care for isolated blunt splenic injuries with satisfactory success rates. However, literature is scarce about the non-operative management of blunt splenic injuries (BSI) with other associated injuries (OAI). The main aim of this study is to assess the applicability of protocol-based NOM in BSI with OAI.Methods: Protocol based resuscitative algorithm was followed for the management of patients with BSI and OAI. NOM was taken up in those patients who were hemodynamically stable and was not attempted in patients who remained hemodynamically unstable or developed hemodynamic instability even after the resuscitative efforts. The data was collected and analyzed.Results: Forty patients with the mean age of 7.05±3.9 years were studied. Fall from height formed the commonest mode of injury. The mean AAST grade was 2.55. The most common association was a left lung contusion (20%). Fifteen patients presented with shock among which two failed the protocol-based resuscitative efforts and were hence explored. One of the patients had lung contusion and the other dorsal vertebral fractures (3rd and 4th). Another patient with mesenteric tear and delayed hemorrhage was operated. Two other patients underwent surgical interventions for bowel perforation and fracture of right femur respectively. Spleen was preserved in both of these patients. Though, the NOM was successful in overall 87.5% patients, spleen specific success rate was 92.5%.Conclusions: Application of protocol-based NOM in patients with BSI with OAI is highly successful if instituted in properly selected patients especially those with low grades of injury and also in those with delayed presentation.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Application of non-operative management protocol in pediatric blunt splenic injuries with other associated injuries

et al. 2019

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“…These results were comparable with that in literature. 8,9 Out of 45 patients with abdominal injuries, multiple intraabdominal solid organ injuries were present in six patients (13.3%) and isolated organ injury was present in 39 patients (86.6%). Two of them had (5%) combination of liver and kidney injuries, four patients had combination of spleen and kidney injuries.…”

Section: Discussionmentioning

confidence: 99%

Management of blunt trauma abdomen in a tertiary care teaching hospital: a surgical audit

2018

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Background: Blunt abdominal trauma is a common scenario in Emergency department and the common cause being road traffic accidents. With this study we present our experience with blunt trauma of abdominal solid organ injuries over a period of 12 months.Methods: A retrospective study was conducted among 45 blunt trauma of abdominal solid organ injuries who presented to the emergency room of Department of General Surgery of Mysore Medical College and Research Institute, Mysore from 1st January 17 to 31st December 2017.All date were retrieved from medical records and statistical analysis was performed using Epi info version 7.Results: Mean age of study population was 31.46 years. 78.2% of the patients were males. Thirty-three (73.3%) patients undergone non-operative management. Splenic injury was reported as the most common abdominal solid organ injury followed by liver.Conclusions: With the advent of newer investigative modalities like contrast enhanced computed tomography (CECT) abdomen, more and more cases of blunt trauma abdominal solid organ injury can be managed non-operatively with effective ICU care. High-grade injuries do not preclude non-operative management.

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“…Intraabdominal injuries occur as a result of blunt abdominal trauma (BAT) or penetrating trauma, being BAT the most common cause (85%) and penetrating trauma accounting for only a minority (15%). Abdominal trauma is the third cause of death in children over 1 year of age [1,2]. Intraabdominal injuries are present in 5-10% of all BATs [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…Other causes are sport injuries, falls and child abuse. Sport injuries usually cause isolated organ injury [1,2].…”

Section: Introductionmentioning

confidence: 99%

The Challenge of Blunt Abdominal Trauma in Children: Report of a Case and Review of Management

Bravo

Aguado-Lopez

2017

J Med Cases

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Blunt abdominal trauma is the most frequent cause of abdominal injuries in children. The term solid organ injury (SOI) is referred to liver, spleen and kidney. Splenic injuries are the most common. The management of SOI has been motive of discussion for years and has undergone a radical shift in the last decades. Currently, non-operative management is the gold standard of care when circumstances are favorable. In 1977, non-operative management was supported by surgeons in Toronto. Later, the American Pediatric Surgical Association (APSA) pointed that management should be based on imaging findings and CT grading of the American Association for the Surgery of Trauma. However, this caused long stays and unnecessary follow-up imaging. Soon, APSA guidelines were questioned and raised controversy. Finally, hemodynamic status was defined as the main key for taking decisions and ATOMAC guidelines gained support. However, facing a blunt trauma in children is always a challenge. Hemodynamic stability is not easy to define and heart rate and blood pulse are poor markers for stability. This complicates the management of blunt trauma in children. As consequence, it is important that these children are treated in pediatric centers. We report a case of a 15-year-old male who suffered from a blunt abdominal trauma with splenic and renal injuries treated by adult surgeons when playing football. We review the current recommendations for blunt abdominal trauma in children and the differences with adult management.

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Blunt Trauma in Pediatric Patients- Experience from Small Center

Abstract: ABSTRACT

Cited by 9 publications

References 18 publications

Application of non-operative management protocol in pediatric blunt splenic injuries with other associated injuries

Application of non-operative management protocol in pediatric blunt splenic injuries with other associated injuries

Management of blunt trauma abdomen in a tertiary care teaching hospital: a surgical audit

The Challenge of Blunt Abdominal Trauma in Children: Report of a Case and Review of Management

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