Selective Nonoperative Management of Penetrating Abdominal Injuries in Children

Çığdem, Murat Kemal; Önen, Abdurrahman; Sığa, Mesut; Otcu, Selçuk

doi:10.1097/ta.0b013e3181bbd932

Cited by 16 publications

(11 citation statements)

References 24 publications

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“…There is a high rate of solid organ injury in blunt trauma to the abdomen while firearm and other penetrating injuries often injure hollow organs, requiring operative management [20]. These studies are largely patients with stab wounds but include some firearm injuries and base non-operative management on clinical exam findings suggesting lack of major injury and hemodynamic stability.…”

Section: Discussionmentioning

confidence: 97%

“…Non-operative management of blunt injuries is widely accepted and in the past twenty years non-operative management of penetrating injuries has been discussed in both adult and pediatric populations [19][20][21][22]. There is a high rate of solid organ injury in blunt trauma to the abdomen while firearm and other penetrating injuries often injure hollow organs, requiring operative management [20].…”

Section: Discussionmentioning

confidence: 99%

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Trends in pediatric firearm-related injuries over the past 10 years at an urban pediatric hospital

Veenstra

Patel

Donoghue

et al. 2015

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Trends in pediatric firearm-related injuries over the past 10 years at an urban pediatric hospital

Veenstra

Patel

Donoghue

et al. 2015

Journal of Pediatric Surgery

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“…Since the present child was stable, initially he was managed conservatively. 8 Ileal perforations can be treated by simple primary repair, resection and anastomosis or ostomy. 5 The present case underwent a primary repair because the contamination was minimal, and the ileal tear was only in the antimesenteric border of ileum.…”

Section: Discussionmentioning

confidence: 99%

Multiple stab injuries in an infant with silent bowel perforations: a case report

Darlington

Anitha

2018

Int Surg J

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Penetrating injuries of the abdomen occur rarely in infants and are mostly accidental. Non-accidental injuries are very rare. We report an infant boy who was stabbed by his father, at sixteen sites all over his abdomen and chest, with a pair of scissors. The child was clinically stable on presentation but omentum was seen protruding from one of the stab wounds. There was no evidence of peritonitis and imaging was normal. The stab wounds were explored, and laparotomy was performed. Intra-operatively, there was a sealed gastric perforation, a mesenteric tear and a long ileal laceration, which were all repaired primarily. In our case, though imaging was normal, a high clinical suspicion and early laparotomy reduced the morbidity and avoided mortality. This case report emphasizes the high index of suspicion for intra-abdominal injuries needed in penetrating abdominal injuries and the need for early exploration even if imaging and clinical status dictate otherwise.

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“…More recently a systematic review of SNOM of blunt hepatic (or splenic) trauma in children in whom there is a contrast blush on CT suggests that the failure rate of nonoperative management is much higher -28.2% without the use of embolisation, although the liver specific data records 3/29 failures (10.3%) [125]. A report from Turkey details successful SNOM of penetrating abdominal wounds in children, although it appears that the majority did not injure any intra-abdominal viscera and liver specific data are not reported though it is likely that some of the successful cases of SNOM did have liver involvement [126].…”

Section: Snom In Childrenmentioning

confidence: 99%

Non-Operative Management of Liver Trauma

Swift

Garner

2012

J R Army Med Corps

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The liver is one of the commonest intra-abdominal organs injured worldwide in blunt and penetrating trauma and its management has evolved significantly in the last 30 years. Mandatory laparotomy has been replaced by an acceptance that for most blunt hepatic trauma, a selective non-operative approach is safe and effective with a failure rate ie the need to proceed to delayed laparotomy of approximately 10%. There is a markedly lower rate of complications in those that are managed non-operatively. Adjuncts to this conservative regimen such as angioembolisation and delayed laparoscopy to treat biliary peritonitis increase the chances of avoiding laparotomy. This belief in non-operative management has also been transferred to some degree to penetrating liver trauma, where there is a gradual accumulation of evidence to support this non-operative approach in a carefully selected group of patients. This article examines the evidence supporting the selective non-operative management of both blunt and penetrating liver trauma and describes the outcomes and complications.

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Selective Nonoperative Management of Penetrating Abdominal Injuries in Children

Abstract: The majority of abdominal stab wound and many gunshot wounds can initially be managed nonoperatively in children, when there is no hemodynamic instability or signs of hollow viscus perforation.

Cited by 16 publications

References 24 publications

Trends in pediatric firearm-related injuries over the past 10 years at an urban pediatric hospital

Trends in pediatric firearm-related injuries over the past 10 years at an urban pediatric hospital

Multiple stab injuries in an infant with silent bowel perforations: a case report

Non-Operative Management of Liver Trauma

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