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Management of Solid Organ Trauma in Pediatrics: A Review of 146 Cases

This study analyzes 146 pediatric patients with solid organ trauma from 2009 to 2013. Direct admissions comprised 44% of the cases, with a predominance of male patients (74%). Key indicators included elevated transaminases and signs like handlebar marks and abdominal tenderness. The study highlights that despite the seemingly benign mechanisms of injury, solid organ trauma requires cautious management. Contrast-enhanced CT is recommended for diagnosis, and conservative management is advocated, with ongoing efforts to develop a comprehensive in-patient guideline.

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Management of Solid Organ Trauma in Pediatrics: A Review of 146 Cases

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  1. Solid Organ trauma an Offally good approach Juliette King Department Paediatric surgery Starship

  2. Haggis

  3. Background

  4. 1/1/09-31/12/2013 • 146 patients identified from the prospectively managed trauma database. • 10 excluded as did not have injury of Liver, Spleen, Kidney, Pancreas. • 44% were direct admissions the rest transferred in

  5. Demographics • Age Mean 9 (1-15) • Sex 74% Male • 3 deaths from other injuries

  6. Mechanism

  7. Tests • Elevated transaminases • Decreased haemaglobin • Micro or macroscopic haematuria • Elevated amylase

  8. Ethnicity

  9. Signs and symptoms • Handlebar marks • Bruises over flanks • Unconscious patient • Abdominal tenderness • Seat belt marks • Chest or pelvic injury

  10. Organ Injured

  11. AAST Grading Liver http://www.aast.org/library/traumatools/injuryscoringscales.aspx

  12. Grade of Injury

  13. Length of stay

  14. APSA guidelines

  15. Conclusion • Solid organ trauma is common and can have fairly benign seeming mechanisms of injury. • If they are suspected contrast enhanced CT is the imaging of choice • They can usually be managed conservatively following grading by CT • We are still very conservative in our management. • We are looking to creating a guideline for in patient stay.

  16. References • Hynick et al 2013 J Trauma AcuteCareSurgVolume 76, Number 1 • Stylianos Journal of Pediatric Surgery, Vol 35, No 2 (February), 2000: pp 164-169 • Aguyau et al Journal of Pediatric Surgery (2010) 45, 1311–1314 • Leinwand et al Journal of Pediatric Surgery, Vol 39, No 3 (March), 2004: pp 487-490 • St Peter et al Journal of Pediatric Surgery (2013) 48, 2437–2441 • Yang et al Journal of Pediatric Surgery (2008) 43, 2264–2267

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