BLUNT ABDOMINAL TRAUMA IN CHILDREN WITH SOLID ORGANS INJURIES; EXPERIENCE IN 24 CASES

Aim: Although operative-management was the standard for blunt abdominal trauma (BAT) in children, recently a non-surgical approach was recommended for pediatric solid-organs-injuries. Methods: To determine the role of conservative approach in BAT children, we retrospectively analyze the data of children with (BAT) solid-organs-injuries managed by the authors over 4 years. Results: From December,/2000 through December,12004, 24 children with (BAT) solid- organs-injuries were managed. Injury mechanisms were road-traffic-accidents (RTA) in 19 (79%), sport-related in 4 (17%) and falling-from-height in 1(4%). The spleen was injured in 13 (54%); the liver in 12 (50%), the kidneys in 3 (13%), and the adrenal-glands in 2 (8%). Thirteen cases were managed conservatively (53%), and 11 operatively (47%). Operations for the spleen (6) included, splenectomy in 3 (50%), partial splenectomy in 2 (33%) and splenorraphy in 1(17%), for the liver (6), suturing tears in 4 (67%) and perihepatic packing in 2 (33%). Four children (17%) died from their injuries; (2) severe chest-injuries, (1) spinal-fracture, and (1) severe liver-injury. Conclusions: Children with BAT solid-organs injuries can be treated without surgery if the decision is based-on their hemodynamicstatus response to resuscitation. Management in pediatric-trauma-centers, with the involvement of pediatric surgeons gives the best outcome