A 38-year-old woman presented with shock and severe abdominal pain. Abdominal CT scanning demonstrated massive ascites, which was highly suggestive of haemoperitoneum. Diagnostic paracentesis confirmed haemoperitoneum. Urgent operative treatment with ligation of a ruptured ovarian varix successfully controlled the bleeding. She eventually made a full recovery.
Background: Trauma is one of the important causes of death for children in Japan. However, there is a lack of epidemiologic data regarding major pediatric trauma injuries. As a result, the number of patients, the necessity of medical resources and medical outcomes are unknown. Objective: To estimate the necessity for pediatric trauma ICU (PT-ICU) beds in Okayama prefecture, we conducted an epidemiologic survey. Method: We conducted a retrospective cohort study involving nine ICUs in Okayama prefecture, which accept major pediatric trauma patients. Patients included in the survey were 14 years of age or younger and admitted to ICUs due to blunt or penetrating trauma. Results: Between January 2008 and December 2010, a total of 149 patients were included in this survey. Of these patients, 119 (79.9%) were hospitalized at tertiary medical centers. For 97.1% of the observation period (1,064/1,096 days), the number of patients was two or less per day. The adequate number of PT-ICU beds was estimated to be one for every 100,000 people aged 14 or less. Conclusion: In Okayama prefecture, major pediatric trauma patients are centralized to tertiary medical centers and their treatment outcome is acceptable. By assigning the adequate number of PT-ICU beds in designated hospitals, an improvement in trauma care can be expected.
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