Prognostic Factors for Paediatric Abdominal Trauma at Tertiary Care Center
Iranian Journal of Pediatric Surgery,
Vol. 9 No. 1 (2023),
11 May 2023
,
Page 84-97
https://doi.org/10.22037/irjps.v9i1.38996
Abstract
Introduction: Paediatric abdominal trauma incidence increasing due to rising population, industrialization, modernization, increase in the vehicular traffic, terrorist activities and riots. This study is done to know the prognostic factors in paediatric abdominal trauma which help in decreasing morbidity and mortality.
Material and Methods:
This retrospective study was conducted at a tertiary care centre, from May 2016 to April 2022. Retrospectively records of all the paediatric patients with a history of abdominal trauma were analysed from case files. Demographic data, mode of injury, mechanism of injury, nature of the injury, definitive treatment and outcome of patients were analysed.
Results:
There were 110 paediatric abdominal trauma patients. Road traffic accidents was the most common mode of trauma seen in 70% of cases, followed by fall which comprises25.5% cases. 25 (22.7%) cases were hemodynamically unstable on presentation.70 (63.6%) cases required transfusion of blood or blood products. Penetrating abdominal trauma was seen in 19 (17.3%) cases, while blunt trauma seen in 91 (82.7%) cases, most common solid organ of injury was spleen seen in 46 (41.8%) cases, Surgical interventions were required in 29(26.4%) cases, however 81(73.6%) cases were managed conservatively. All patients of traumatic bowel perforation required surgical intervention. Nine (08.1%) patients were succumbed to death. Among the factors leading to mortality, delayed presentation (78%), hemodynamic instability (89%), requirement of transfusion (100%), penetrating abdominal trauma (78%), higher grade injury (67%), surgical interventions (89%) were commonly identified and were poor prognostic factors.
Conclusion: Delayed presentation, hemodynamic instability, penetrating abdominal trauma, higher grade of injury, surgical intervention are the poor prognostic factors. Site of injury, mechanism and the mode of injury are other factors contributing and deciding prognosis in paediatric abdominal trauma.
- abdominal trauma, paediatric, spleen injury, bowel injury, road traffic accidents.
How to Cite
References
Lynch T, Kilgar J, Al Shibli A; Pediatric Abdominal Trauma. CurrPediatr Rev 2018;14(1):59-63.
Schacherer N, Miller J, Petronis K; Pediatric blunt abdominal trauma: recognition and management in the emergency department. PediatrEmerg Med Pract 2020;17(1):1-59.
Holmes JF, Sokolove PE, Brant WE, et al; Identification of children with intra-abdominal injuries after blunt trauma. Annals of emergency medicine. 2002 May 1;39(5):500-9.
Kundal VK, Debnath PR, Sen A; Epidemiology of pediatric trauma and its pattern in urban India: A tertiary care hospital-based experience. Journal of Indian Association of Pediatric Surgeons. 2017 Jan;22(1):33.
Wegner S, Colletti JE, Van Wie D; Pediatric blunt abdominal trauma. Pediatr Clin North Am. 2006;53(2):243-56.
Rao CB, Mallepalli R, Reddy PS, et al; Clinical Study of Pediatric Abdominal Trauma. J Contemp. MedRes2019;6(1): A1-A5.
Suominen JS, Pakarinen MP, Kääriäinen S,et al; In-hospital treated pediatric injuries are increasing in Finland—a population-based study between 1997 and 2006. Scandinavian journal of surgery. 2011 Jun;100(2):129-35.
Stylianos S; Outcomes from pediatric solid organ injury: role of standardized care guidelines. Current opinion in pediatrics. 2005 Jun 1;17(3):402-6.
Nnamonu MI, Ihezue CH, Sule AZ, et al; Diagnostic value of abdominal ultrasonography in patients with blunt abdominal trauma. Niger J Surg 2013;19(2):73-8.
Notrica DM; Pediatric blunt abdominal trauma: current management. CurrOpin Crit Care 2015;21(6):531-537.
IBM Corp. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp. Released 2016.
Molcho M, Walsh S, Donnelly P, et al; Trend in injury-related mortality and morbidity among adolescents across 30 countries from 2002 to 2010. Eur J Public Health 2015;25(2):33–6.
Adesunkanmi AR, Oginni LM, Oyelami AO, et al; Epidemiology of childhood injury. J Trauma 1998; 44:506-12.
Karbakhsh M, Zargar M, Zarei MR, et al; Childhood injuries in Tehran: a review of 1281 cases. The Turkish journal of pediatrics. 2008 Jul 1;50(4):317.
Sharma M, Lahoti BK, Khandelwal G, et al; Epidemiological trends of pediatric trauma: A single-center study of 791 patients. J Indian Assoc Pediatr Surg 2011; 16:88–92.
Notrica DM, Eubanks JW, Tuggle DW, et al; Nonoperative management of blunt liver and spleen injury in children: Evaluation of the ATOMAC guideline using GRADE. J Trauma Acute Care Surg 2015;79(4):683-693.
Holmes JF, Brant WE, Bond WF, et al; Emergency department ultrasonography in the evaluation of hypotensive and normotensive children with blunt abdominal trauma. J Pediatr Surg 2001; 36:968-73.
Sivit C J; Imaging Children with Abdominal Trauma.Am. J. Roentgenol2009 192:5, 1179-89.
Matsushima K, Mangel PS, Schaefer EW, et al; Blunt hollow viscus and mesenteric injury: still underrecognized. World J Surg 2013;37(4):759-65.
Canty TG Sr, Canty TG Jr, Brown C; Injuries of the gastrointestinal tract from blunt trauma in children: a 12-year experience at a designated pediatric trauma center. J Trauma 1999;6(2):234-40.
Chirdan LB, Uba AF, Chirdan OO; Gastrointestinal injuries following blunt abdominal trauma in children. Niger J Clin Pract 2008;11(3):250-3.
Gutierrez IM, Ben-Ishay O, Mooney DP; Pediatric thoracic and abdominal trauma. Minerva Chir2013; 68:263–74.
Letton RW, Worrell V; APSA Committee on trauma blunt intestinal injury study group delay in diagnosis and treatment of blunt intestinal injury does not adversely affect prognosis in the pediatric trauma patient. J Pediatr Surg. 2010 Jan;45(1):161-5.
Gaines BA, Ford HR; Abdominal and pelvic trauma in children. Crit Care Med 2002;30: S416–23.
Singer G, Arneitz C, Tschauner S, et al; Trauma in pediatric urology. InSeminars in Pediatric Surgery 2021 Aug 1 (Vol. 30, No. 4, p. 151085). WB Saunders.
Burns J, Brown M, Assi ZI, et al; Five-year retrospective review of blunt renal injuries at a level i trauma center. Am Surg 2017;83(2):148-56.
Keller MS; Blunt injury to solid abdominal organs. Semin Pediatr Surg 2004; 13:106–11.
Safavi A, Beaudry P, Jamieson D, et al; Traumatic pseudoaneurysms of the liver and spleen in children: is routine screening warranted? J Pediatr Surg2011;46(5):938-941.
Notrica DM; Pediatric blunt solid organ injury: Beyond the APSA guidelines. CurrSurg Rep 2015; 3:1–6.
- Abstract Viewed: 105 times
- PDF Downloaded: 95 times