ABDOMINAL TRAUMA IN PEDIATRIC AGE

Abstract

Aim of the study: to value the appropriateness and the efficacy of non-operative treatment in children with blunt abdominal trauma.

Patients and methods: in this research, 14 children with abdominal trauma, secondary mostly to road accidents, were studied; 9 of these had single organ injury while 5 had multiple organ injuries. Spleen has been the most injuried organ (9 children), followed by liver (5 cases) and kidney (2 cases). Five children were admitted at emergency department in hypovolemic conditions, promptly corrected by resuscitative measures. All patients underwent abdominal ultrasound and/or C.T. scans in order to detect any intraperitoneal free fluid or organic injuries. Six children (43%) were followed by non-operative treatment, while other eight underwent surgery.

Results: all children, those treated conservatively as well as those operated, were cured, without any important complication.

Discussion and conclusions: nowadays, with the great help of ultrasound and C.T. scans, is possible to treat 40-50% of children affected by abdominal trauma with non-operative measures, with return to normal functions by the injuried organs. The surgical approach is today accomplished only in presence of severe injuries or haemodynamic instability resistant to resuscitative treatment. The majority of Authors in the literature agree on the usefulness of non-operative treatment, especially for children. Regarding surgical treatment, in the near future probably we’ll see a larger application of laparoscopic techniques also in the field of abdominal traumatology.