26 A 9 year experience of Abdominal Trauma in children in a UK Major Trauma Centre
Shehryer Naqvi1, Chandrasen Kumar Sinha2
1St Georges Hospital NHS Foundation Trust, London, United Kingdom. 2St. Georges Hospital NHS Foundation Trust, London, United Kingdom

Abstract

Aim of the Study

To investigate the 9 year experience of a UK Major Trauma Centre in the management of abdominal trauma in children and formulate an algorithm for their management.

Methods

All trauma admissions between April 2008 and July 2017 were identified using HES data and a retrospective review of a prospectively held database. Abdominal trauma cases were then interrogated. Outcomes collected were patient demographics, method of injury, injury and subsequent management.

Main Results

587 trauma admissions were identified. 150 of these admissions included abdominal trauma. 117/150 (78%) were male with a median age of 12 years. Blunt trauma accounted for 113 (75%) of cases. Multi-organ abdominal injury was present in 16/150 (10%) and additional extra abdominal injuries were present in 50/150 (33%). One mortality was identified. Operative intervention was instituted in 21/150 (14%) patients. The intervention was laparotomy in 17/21 (81%), laparoscopy in 3/21 (14%) and a groin exploration in one patient (5%).

Operative interventions included packing for haemorrhage in 5/21 (24%), repair of duodenal injury in 4/21 (19%), repair of small bowel injury in 5/21 (24%) and partial splenectomy in 1/21 (5%). Two laparoscopies were performed and revealed no pathology.

Conclusion

Abdominal injury occurs in 25% of all admitted trauma patients. The majority of abdominal trauma can be managed conservatively. Small bowel perforation is the most common finding at laparotomy followed closely by duodenal perforation. . Mortality is rare in children. The findings of this retrospective review of our practice have been used to formulate a new trauma algorithm for children with abdominal trauma.


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