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Abstract
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Post-traumatic stress disorder (PTSD) is a frequently overlooked mental disorder among children who have experienced accidental injuries.1, 2, 3 In April 2017, our hospital admitted an 11-year-old child who had suffered severe multiple injuries due to a car accident. Upon admission, the child was already in a state of hemorrhagic shock. Despite the collaborative efforts of multiple departments in the hospital, the child managed to survive and regain the ability to perform basic self-care. However, it was observed that the child developed PTSD after being discharged. The details of this case are reported as follows.
In April 2017, an 11-year-old girl was involved in a car accident and suffered abdominal injuries. After receiving initial emergency treatment at a local hospital, the child was transferred to our hospital. Upon admission, the child exhibited clear symptoms of shock, with cold and wet limbs and unconsciousness. Immediate anti-shock treatment was administered, and relevant departments were notified to prepare for emergency surgery. Emergency imaging revealed no skull trauma, but identified left traumatic diaphragmatic hernia, bilateral traumatic wet lung, liver contusion, right iliac fracture, and sacral fracture (Fig. 1). Subsequently, the child underwent emergency surgery with the collaborative assistance of multiple departments. During the operation, the abdominal cavity was opened, revealing a significant amount of dark red blood (approximately 500 ml) within. The abdominal intestinal tube was found to be widely dilated, and there was a tear in the envelope of the right posterior lobe of the liver, along with contusion of the liver parenchyma (Fig. 1). A laceration of approximately 8 cm in length was observed at the root of the mesentery, accompanied by extensive contusion and bleeding of the mesenteric vessels. Despite these injuries, the intestinal blood flow remained acceptable. Additionally, a 10 cm long tear at the esophageal hiatus of the left diaphragm allowed the fundus and spleen to herniate into the left chest cavity. Furthermore, the exploration revealed the formation of an extensive retroperitoneal hematoma. After undergoing 200 min of emergency surgery, the child was successfully transferred back to the intensive care unit for postoperative treatment. Following a meticulous and lengthy treatment period of 7 months, the child was eventually discharged from the hospital. However, during our subsequent follow-up visit, we discovered that the child experienced significant behavioral and emotional issues six months after leaving the hospital. These symptoms included day and night panic, recurring memories and nightmares, avoidance of triggering stimuli, irritability, and a general loss of interest in activities. The local psychiatric hospital diagnosed the child with PTSD, and with appropriate treatment, the child's condition improved, leading to discharge from the hospital. Despite the improvement, the child is still unable to attend school...
Language: en |