Autor:innen:
T. Popoiu (Timisoara, RO)
C. Stanciulescu (Timisoara, RO)
V. David (Timisoara, RO)
E. Iacob (Timisoara, RO)
V. Pinzaru (Timisoara, RO)
M. Neagu (Timisoara, RO)
C. Popoiu (Timisoara, RO)
Introduction:
Child trauma represent nowadays a leading cause of mortality. For children with mild trauma who are clinically stable, FAST is enough for the evaluation.
Materials and methods:
312 children admitted between 2017-2022 in our department, had been retrospectively examined, regarding blunt abdominal trauma. The physical exam findings, radiologic imaging, as well as our clinical and surgical approach of the spleen, pancreas, small intestine and kidney trauma were taken into consideration. In this study we focused on splenic trauma. Management options were nonoperative, splenorraphy and splenectomy. Patients under 18 years old with registered splenic injury were identified.
Results: The most relevant causes of child abdominal trauma were motor vehicle accident (18), falls from height (6), fall from a trampoline (1) and aggression (1). We have performed CT-scan in only 10 of our patients. The average age concluded from our study is 11 years 4 months and the average hospital admission was 14,076 days (1-84 days). From a total of 312 children with multiple trauma injuries, 84 had liver injury, 26 splenic, 20 renal, 9 pancreatic, and 5 small intestine injuries.
From the patients with splenic trauma, 10 patients underwent surgical treatment (6 patients had emergency splenectomy, 4 splenorraphy), 9 patients benefited from non-operative treatment, and the rest of 7 had others surgical procedures. Due to multiple severe trauma injuries, 2 patients have lost their lives.
Conclusion: The optimal surgical approach, should take into consideration injury severity, hemodynamic status of the patient, and associated lesions. Abdominal CT scan should be performed if FAST ultrasound is inconclusive. Although the gold standard of splenic lesions is nonoperative treatment, the pediatric surgeon should be always ready for surgical intervention.