Publication:

Abdominal blunt trauma in children: experience from a single center

Background Abdominal blunt trauma (ABT) remains an important cause of childhood morbidity and sometimes, mortality. Recently the approach for management of ABT has tilted towards conservative one with excellent results. In this study, we present our experience of ABT from a teaching hospital.

Methods All patients below 17 years with ABT between December 2012 and May 2016 were studied retrospectively and methods and results analyzed.

Results A total of 33 patients presented with ABT, mainly due to fall from height or road-traffic accidents. Age ranged from 3 to17 years. Of the 33 patients, 30 patients had solid organ injuries and only 3 patients had isolated hollow viscus injuries. Operative intervention was needed in 6 (18.2%) patients, of whom three needed upfront surgery. They had had hollow viscus injury. Others who developed signs and symptoms of other injuries included duodenal injury, ureteric transection and delayed adhesive intestinal obstruction following bile leak, one each. Average hospital stay of patients with solid organ injury was 5.4±1.6 days while for those with hollow viscus injury requiring operative intervention, this was 12.3±2.4 days. There was no mortality.

Conclusions ABT is a frequent emergency in children in the developing world. Prompt initial management significantly affects the eventual outcome. Imaging studies are the cornerstone of diagnosing the type and extent of injury. Most patients can be managed conservatively. However, constant masterly vigilance is needed to pick up the evolving signs, thereby avoiding possible complications and morbidity.