Factores asociados a falla en el manejo no operatorio de lesiones hepáticas o esplénicas secundarias a trauma abdominal cerrado en niños

Medina, Adriana Echavarria; Uribe, Carlos Hernándo Morales; R, Luis Guillermo Echavarria; Marín, Viviana María Vélez; Montoya, Jorge Alberto Martínez; Aguillón, David

doi:10.4067/s0370-41062017000400005

Rev. chil. pediatr.

2017

DOI: 10.4067/s0370-41062017000400005

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Factores asociados a falla en el manejo no operatorio de lesiones hepáticas o esplénicas secundarias a trauma abdominal cerrado en niños

Adriana Echavarria Medina

Carlos Hernándo Morales Uribe

Luis Guillermo Echavarria R

et al.

Abstract: Results: 70 patients were admitted with blunt abdominal trauma, 3 were excluded for immediate surgery (2 hemodynamic instability, 1 peritoneal irritation). Of 67 patients who received NOM, 58 were successful and 9 showed failure (8 hemodynamic instability, 1 hollow viscera injury). We found 3 factors associated with failure NOM: blood pressure (BP) < 90 mmHg at admission (p = 0.0126; RR = 5.19), drop in hemoglobin (Hb) > 2 g/ dl in the first 24 hours (p = 0.0009; RR = 15.3), and transfusion of 3 or more units … Show more

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Cited by 4 publications

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Single centre analysis of factors influencing surgical treatment of splenic trauma in children

Zhao,

Hao,

et al. 2024

Journal of Tropical Pediatrics

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Objective This study aims to investigate determinants impacting the surgical management of splenic trauma in paediatric patients by scrutinizing age distribution, etiological factors and concomitant injuries. The analysis seeks to establish a foundation for delineating optimal operative timing. Methods A cohort of 262 paediatric cases presenting with splenic trauma at our institution from January 2011 to December 2021 underwent categorization into either the conservative or operative group. Results Significantly disparate attributes between the two groups included age, time of presentation, blood pressure, haemoglobin levels, blood transfusion requirements, thermal absorption, American Association for the Surgery of Trauma (AAST) classification and associated injuries. Logistic regression analysis revealed age, haemoglobin levels, AAST classification and blood transfusion as autonomous influencers of surgical intervention (OR = 1.024, 95% CI: 1.011–1.037; OR = 1.067, 95% CI: 1.01–1.127; OR = 0.2760, 95% CI: 0.087–0.875; OR = 7.873, 95% CI: 2.442–25.382; OR = 0.016, 95% CI: 0.002–0.153). The AAST type and age demonstrated areas under the receiver operating characteristic (ROC) curve of 0.782 and 0.618, respectively. Conclusion Age, haemoglobin levels, AAST classification and blood transfusion independently influence the decision for surgical intervention in paediatric patients with splenic trauma. Age and AAST classification emerge as viable parameters for assessing and prognosticating the likelihood of surgical intervention in this patient cohort.

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Single centre analysis of factors influencing surgical treatment of splenic trauma in children

Zhao,

Hao,

et al. 2024

Journal of Tropical Pediatrics

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Clinical value of CT diagnosis in abdominal trauma

Li¹,

Zhang²,

Wang³

et al. 2018

biomedicalresearch

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Objective: This paper discusses the clinical value of CT diagnosis in abdominal trauma. Method: Eighty patients with abdominal trauma admitted in our hospital from April 2015 to July 2017 were selected and subjected to B-ultrasonography and CT scan. Surgical and pathological diagnoses were used as the gold standard. The two diagnostic methods were compared in terms of sensitivity, specificity, accuracy, and diagnosis accordance rate of organ injury in the abdomen. Results: Based on surgical and pathological diagnoses, 75 of 80 patients (93.8%) were confirmed to have organ injury in the abdomen and included 25 patients with spleen damage, 13 patients with liver damage, 10 patients with kidney damage, 10 patients with pancreas damage, 9 patients with small intestine/duodenum damage, and 8 patients with peritoneum damage. The sensitivity, specificity, and accuracy of B-ultrasonography are 82.6%, 80.0%, and 82.5%, which are not significantly different from those of CT scan (90.7%, 80.0%, and 90.0%) (P>0.05). The diagnosis accordance rates of Bultrasonography in the spleen, liver, kidney, pancreas, small intestine/duodenum, and peritoneum damages are 92.0%, 92.3%, 100.0%, 80.0%, 77.8%, and 75.0%, respectively, and those of CT scan are 100.0%, 100.0%, 90.0%, 90.0%, 100.0%, and 87.5%, respectively; the difference between the two methods is not significant (P>0.05). Conclusions: B-ultrasonography and CT scan present similar clinical results in abdominal trauma diagnosis. These procedures are noninvasive, simple to operate, and worthy of further clinical promotion and application.

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Traumatismo hepático cerrado

Nivelo Zumba,

Lizarzaburu Penafiel,

Castro Pomaquiza

et al. 2023

LATAM

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El trauma acarrea importantes tasas de mortalidad y discapacidad a nivel mundial, mientras que el traumatismo abdominal cerrado exige de manejo multidisciplinario, en especial cuando se documenta traumatismo hepático, cuyo tratamiento continúa simbolizando un desafío para el cirujano. El objetivo fue analizar el manejo del traumatismo hepático cerrado. La investigación se ha encaminado de acuerdo con el enfoque cualitativo, se realizó en una revisión documental, incluyendo artículos desarrollados entre 2017 – 2023, para ello fueron consultadas las bases de datos: MEDLINE, Scopus, Scholar academic, SciELO y Embase. Fueron seleccionados 12 artículos en la revisión. En los resultados debe indicarse que los pacientes afectados por el traumatismo hepático cerrado suelen pertenecer al sexo masculino, el mecanismo de lesión más frecuente es el accidente de tránsito, conllevando principalmente a lesiones grado II y III. Las lesiones extraabdominales más observadas son las torácicas, y a nivel abdominal la mayor afectación la experimenta el bazo. En cuanto al tratamiento, se ha evidenciado que el manejo no operatorio es la principal opción terapéutica implementada, especialmente en pacientes hemodinámicamente estables. En casos más severos, el seguimiento clínico, paraclínico e imagenológico permite reconocer la necesidad de intervención quirúrgica, En conclusión, el manejo no operatorio del trauma hepático cerrado continúa representando una alternativa terapéutica efectiva y segura en casos con estabilidad hemodinámica, en ausencia de peritonitis y lesiones asociadas que requieran intervención quirúrgica, puesto que la tasa de éxito así lo respalda.

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Factores asociados a falla en el manejo no operatorio de lesiones hepáticas o esplénicas secundarias a trauma abdominal cerrado en niños

Cited by 4 publications

References 24 publications

Single centre analysis of factors influencing surgical treatment of splenic trauma in children

Single centre analysis of factors influencing surgical treatment of splenic trauma in children

Clinical value of CT diagnosis in abdominal trauma

Traumatismo hepático cerrado

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