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01.12.2023 | Original Article

Management of pediatric blunt abdominal trauma with split liver or spleen injuries: a retrospective study

verfasst von: Ossama M. Zakaria, Mohamed Yasser I. Daoud, Hazem M. Zakaria, Abdulrahman Al Naim, Fatemah A. Al Bshr, Haytham Al Arfaj, Ahmad A. Al Abdulqader, Khalid N. Al Mulhim, Mohamed A. Buhalim, Abdulrahman R. Al Moslem, Mohammed S. Bubshait, Qasem M. AlAlwan, Ahmed F. Eid, Mohammed Q. AlAlwan, Waleed H. Albuali, Ahmed Abdelghany Hassan, Ahmed Hassan Kamal, Rabab Abbas Majzoub, Abdullah Q. AlAlwan, Omar Abdelrahman Saleh

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

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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.

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Titel: Management of pediatric blunt abdominal trauma with split liver or spleen injuries: a retrospective study
verfasst von: Ossama M. Zakaria
Mohamed Yasser I. Daoud
Hazem M. Zakaria
Abdulrahman Al Naim
Fatemah A. Al Bshr
Haytham Al Arfaj
Ahmad A. Al Abdulqader
Khalid N. Al Mulhim
Mohamed A. Buhalim
Abdulrahman R. Al Moslem
Mohammed S. Bubshait
Qasem M. AlAlwan
Ahmed F. Eid
Mohammed Q. AlAlwan
Waleed H. Albuali
Ahmed Abdelghany Hassan
Ahmed Hassan Kamal
Rabab Abbas Majzoub
Abdullah Q. AlAlwan
Omar Abdelrahman Saleh
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05379-0

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Management of pediatric blunt abdominal trauma with split liver or spleen injuries: a retrospective study