Management Of Blunt Trauma In Pediatric Patients: A Single-Center Retrospective Analysis
11the World Society of Emergency Surgery Congress, Rodos, Greece, 25 - 28 June 2024, (Unpublished)
- Publication Type: Conference Paper / Unpublished
- City: Rodos
- Country: Greece
- Istanbul University Affiliated: Yes
Abstract
Background: Blunt trauma often results with injuries to abdominal solid organs. In pediatric trauma population, careful consideration is required to determine whether nonoperative management (NOM) or surgical intervention is appropriate, as well as the optimal approach to imaging modalities.
Methods: The records of pediatric blunt trauma patients with solid organ injuries who were admitted to our trauma department between 2012 and 2023 were analyzed retrospectively.
Results: A total of 141 patients with a median age of 8.4 years were included in the study. Most common injured solid organ was spleen (51.7%), followed by liver (42.5%), kidney (16.3%), and pancreas (3.5%). The median injury grades according to AAST were 2 (1-5) for spleen, liver, and pancreas injuries, and 3 (1-5) for kidney injuries. 12 patients needed surgical intervention and 5 patients needed radiological intervention upon admission, 124 patients were managed nonoperatively. Six patients had pseudoaneurism (PSA) on initial imaging, we perform surgery that is distal pancreatectomy, vascular primary repair and hemostasis for the two patient of them. Seventy six patients underwent follow up computed tomography (CT) with a median interval of 5 days, while 34 patients underwent ultrasonography with a median interval of 4 days. Two more PSA were detected managed with radiological embolization.
The 30- day mortality was 8% and average hospital stay was 8.9 days.
Conclusion: Managing blunt traumas in pediatric patients presents significant challenges in detection and treatment. Careful consideration is required when performing follow-up imaging studies and making treatment decisions.