TY - JOUR PY - 2015// TI - Blunt trauma in paediatric patients - experience from a small centre JO - West Indian medical journal A1 - Djordjevic, I. A1 - Slavkovic, A. A1 - Marjanovic, Z. A1 - Zivanovic, D. SP - e069 EP - e069 VL - 64 IS - 2 N2 - OBJECTIVE: Despite great prevention efforts, blunt abdominal trauma (BAT) still remains a leading cause of injury, especially in the paediatric population. Abdominal trauma is the main culprit of serious children's injury and the most common area of initially missed diagnosis with a fatal outcome.

AIM: The purpose of this study was to determine the incidence, aetiology, grades of abdominal organ injuries, diagnosis, management and outcome of blunt abdominal trauma in a paediatric population.

METHOD: This is a retrospective study of 31 patients with isolated parenchymatous abdominal organs, treated in a single centre. Stable patients with no signs of peritonitis and insignificant changes in laboratory findings were managed conservatively. Unstable patients received surgery.

RESULTS: The leading cause of injuries were traffic accidents (64.5%), followed by fall from a height (22.5%), bicycle handlebar injuries (6.45%), contact sport and child abuse (3.22% each). The majority of injured children (90.32%) were managed conservatively. Only three patients (9.68%) were operated on due to complete avulsion and organ smash, or devascularization of the injured organs. Diagnostic computed tomography (CT) scan examination was performed on 93.5% of patients. Few patients had grade I and grade V injuries, while the largest proportion of patients had grade III and IV injuries. The most frequently injured organs were the spleen and kidney. There was no mortality.

CONCLUSION: The results emphasize that conservative treatment was appropriate for all stable patients with BAT regardless of organ injury grade. The success of non-operative management depends upon proper patient selection. The choice of non-operative treatment should be based predominantly on physiological response, rather than grade injury on CT scan.

Language: en

LA - en SN - 0043-3144 UR - http://dx.doi.org/10.7727/wimj.2014.069 ID - ref1 ER -