Delay in diagnosis and treatment of blunt intestinal injury does not adversely affect prognosis in the pediatric trauma patient

Letton, Robert W.; Worrell, Veronica

doi:10.1016/j.jpedsurg.2009.10.027

Cited by 37 publications

(23 citation statements)

References 23 publications

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“…In their multiinstitutional study, delay in diagnosis, even beyond 24 h, was not uncommon. The delay, however, did not negatively impact outcome [57]. With more than 20% of the patients having severe traumatic brain injury and a GCS less than six, such delays in diagnosis would be expected.…”

Section: Blunt Intestinal Injurymentioning

confidence: 90%

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Pediatric blunt abdominal trauma

Notrica

2015

Current Opinion in Critical Care

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Section: Blunt Intestinal Injurymentioning

confidence: 90%

“…Motorized vehicles and handlebar injuries are the most common mechanisms [36,57]. A review examining the failure of nonoperative management in solid organ injury noted that 15% of failures of nonoperative management of solid organ injury are because of concurrent intestinal injury [36].…”

Section: Blunt Intestinal Injurymentioning

confidence: 99%

Pediatric blunt abdominal trauma

Notrica

2015

Current Opinion in Critical Care

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“…Complications were rare in both operatively managed, and non-operatively managed patients. Especially in the NOM group, the complication rate was considerably lower (5%) than described in the literature [25,[34][35][36][37]. Re-intervention, due to these complications, such as re-bleed or bile leak, was required in only a few cases.…”

Section: Discussionmentioning

confidence: 82%

Management of pediatric blunt abdominal trauma in a Dutch level one trauma center

Spijkerman

Bulthuis

Hesselink

et al. 2020

Eur J Trauma Emerg Surg

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Purpose Most children with intra-abdominal injuries can be managed non-operatively. However, in Europe, there are many different healthcare systems for the treatment of pediatric trauma patients. Therefore, the aim of this study was to describe the management strategies and outcomes of all pediatric patients with blunt intra-abdominal injuries in our unique dedicated pediatric trauma center with a pediatric trauma surgeon. Methods We performed a retrospective, single-center, cohort study to investigate the management of pediatric patients with blunt abdominal trauma. From the National Trauma Registration database, we retrospectively identified pediatric (≤ 18 years) patients with blunt abdominal injuries admitted to the UMCU from January 2012 till January 2018. Results A total of 121 pediatric patients were included in the study. The median [interquartile range (IQR)] age of patients was 12 (8-16) years, and the median ISS was 16 (9-25). High-grade liver injuries were found in 12 patients. Three patients had a pancreas injury grade V. Furthermore, 2 (1.6%) patients had urethra injuries and 10 (8.2%) hollow viscus injuries were found. Eighteen (14.9%) patients required a laparotomy and 4 (3.3%) patients underwent angiographic embolization. In 6 (5.0%) patients, complications were found and in 4 (3.3%) children intervention was needed for their complication. No mortality was seen in patients treated non-operatively. One patient died in the operative management group. Conclusions In conclusion, it is safe to treat most children with blunt abdominal injuries non-operatively if monitoring is adequate. These decisions should be made by the clinicians operating on these children, who should be an integral part of the entire group of treating physicians. Surgical interventions are only needed in case of hemodynamic instability or specific injuries such as bowel perforation.

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“…In a multi-institutional retrospective study of 214 patients diagnosed with bowel injury after trauma, there were no statistically significant differences in the early and late complications or total hospital length of stay based on the time interval from injury to intervention (<6, 6-12, 12-24, and >24 h). The authors concluded that, although operative management should be expeditiously pursued once a diagnosis of bowel injury is established, in those children with unclear findings, especially with other injuries (e.g., traumatic brain injuries), observation and serial examinations may be an appropriate alternative to emergency exploratory laparotomy or repeated CT scans [32].…”

Section: Bowel Injury and Free Intraperitoneal Fluid On Computed Tomomentioning

confidence: 99%