A COMPARATIVE STUDY BETWEEN CONSERVATIVE AND EARLY SURGICAL INTERVENTION OF SOLID ORGANS INJURY AFTER BLUNT ABDOMINAL TRAUMA IN PAEDIATRICS

Document Type : Original Article

Authors

1 Ahmed Maher Teaching Hospital, Cairo, Egypt.

2 Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

3 Department of Pediatric Surgery Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Abstract

Background: Abdominal trauma in pediatrics is common. Abdomen is the most common site of initially unrecognized fatal injury in traumatized children. Aim of the Work: To analyse the value of conservative treatment versus early operative intervention for solid organs injury in the pediatric age group with blunt abdominal trauma. Patients and Methods: The study was carried out by collecting data from a random group of 140 children whose ages ranged from 6 to 16 years who suffered from abdominal trauma associated with solid organ injury, during the period between January 2017 to December 2020, at Ain Shams University hospital, Ahmed Maher teaching hospital and Nasser Institute. A clinical examination was signed for the patients, vital signs were evaluated, the necessary laboratory investigations were carried out, and FAST was performed on the abdomen in the emergency department. Also CT abdomen and pelvis was done on haemodynamic stable patients or after stabilization. Results: The study showed that periods of hospital stay were significantly higher in the surgical treatment group compared to conservative treatment group. Also blood transfusion, need of ICU hospitalization, need of mechanical ventilation and mortality were significantly higher in the surgical treatment group compared to conservative treatment group. The research showed the success of conservative treatment in the treatment of traumatic abdominal injuries, which resulted in injury to the spleen and liver in children, especially low-grade injuries, and that conservative treatment is safe and less expensive compared to surgical intervention. We also support the expansion of the use of interventional radiology in children, as it greatly reduces the child's exposure to surgical intervention. Conclusion: The present study confirmed the effectiveness of NOM in patients with liver and splenic injuries, suggesting a safe and effective therapeutic approach. According to these findings, the majority of patients can be treated with NOM in a less invasive manner, avoiding unnecessary laparotomies. Hemodynamic stability together with injury grading scale will provide a good plan for management.

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Ain Shams Medical Journal
Volume 73, Issue 1
March 2022
Pages 103-114

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