학술논문
Management of pediatric blunt abdominal trauma with split liver or spleen injuries: a retrospective study
Document Type
Original Paper
Author
Zakaria, Ossama M.; Daoud, Mohamed Yasser I.; Zakaria, Hazem M.; Al Naim, Abdulrahman; Al Bshr, Fatemah A.; Al Arfaj, Haytham; Al Abdulqader, Ahmad A.; Al Mulhim, Khalid N.; Buhalim, Mohamed A.; Al Moslem, Abdulrahman R.; Bubshait, Mohammed S.; AlAlwan, Qasem M.; Eid, Ahmed F.; AlAlwan, Mohammed Q.; Albuali, Waleed H.; Hassan, Ahmed Abdelghany; Kamal, Ahmed Hassan; Majzoub, Rabab Abbas; AlAlwan, Abdullah Q.; Saleh, Omar Abdelrahman
Source
Pediatric Surgery International. 39(1)
Subject
Language
English
ISSN
1437-9813
Abstract
Background: Blunt abdominal trauma is a prevailing cause of pediatric morbidity and mortality. It constitutes the most frequent type of pediatric injuries. Contrast-enhanced sonography (CEUS) and contrast-enhanced computed tomography (CECT) are considered pivotal diagnostic modalities in hemodynamically stable patients.Aim: To report the experience in management of pediatric split liver and spleen injuries using CEUS and CECT.Patients and methods: This study included 246 children who sustained blunt abdominal trauma, and admitted and treated at three tertiary hospitals in the period of 5 years. Primary resuscitation was offered to all children based on the advanced trauma and life support (ATLS) protocol. A special algorithm for decision-making was followed. It incorporated the FAST, baseline ultrasound (US), CEUS, and CECT. Patients were treated according to the imaging findings and hemodynamic stability.Results: All 246 children who sustained a blunt abdominal were studied. Patients' age was 10.5 ± 2.1. Road traffic accidents were the most common cause of trauma; 155 patients (63%). CECT showed the extent of injury in 153 patients’ spleen (62%) and 78 patients’ liver (32%), while the remaining 15 (6%) patients had both injuries. CEUS detected 142 (57.7%) spleen injury, and 67 (27.2%) liver injury.Conclusions: CEUS may be a useful diagnostic tool among hemodynamically stable children who sustained low-to-moderate energy isolated blunt abdominal trauma. It may be also helpful for further evaluation of uncertain CECT findings and follow-up of conservatively managed traumatic injuries.