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European Journal of Trauma and Emergency Surgery

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Open Access 01-10-2021 | Laparotomy | Original Article

Management of pediatric blunt abdominal trauma in a Dutch level one trauma center

Authors: Roy Spijkerman, Lauren C. M. Bulthuis, Lillian Hesselink, Thomas M. P. Nijdam, Luke P. H. Leenen, Ivar G. J. M. de Bruin

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2021

Abstract

Purpose

Most children with intra-abdominal injuries can be managed non-operatively. However, in Europe, there are many different healthcare systems for the treatment of pediatric trauma patients. Therefore, the aim of this study was to describe the management strategies and outcomes of all pediatric patients with blunt intra-abdominal injuries in our unique dedicated pediatric trauma center with a pediatric trauma surgeon.

Methods

We performed a retrospective, single-center, cohort study to investigate the management of pediatric patients with blunt abdominal trauma. From the National Trauma Registration database, we retrospectively identified pediatric (≤ 18 years) patients with blunt abdominal injuries admitted to the UMCU from January 2012 till January 2018.

Results

A total of 121 pediatric patients were included in the study. The median [interquartile range (IQR)] age of patients was 12 (8–16) years, and the median ISS was 16 (9–25). High-grade liver injuries were found in 12 patients. Three patients had a pancreas injury grade V. Furthermore, 2 (1.6%) patients had urethra injuries and 10 (8.2%) hollow viscus injuries were found. Eighteen (14.9%) patients required a laparotomy and 4 (3.3%) patients underwent angiographic embolization. In 6 (5.0%) patients, complications were found and in 4 (3.3%) children intervention was needed for their complication. No mortality was seen in patients treated non-operatively. One patient died in the operative management group.

Conclusions

In conclusion, it is safe to treat most children with blunt abdominal injuries non-operatively if monitoring is adequate. These decisions should be made by the clinicians operating on these children, who should be an integral part of the entire group of treating physicians. Surgical interventions are only needed in case of hemodynamic instability or specific injuries such as bowel perforation.

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Title: Management of pediatric blunt abdominal trauma in a Dutch level one trauma center
Authors: Roy Spijkerman
Lauren C. M. Bulthuis
Lillian Hesselink
Thomas M. P. Nijdam
Luke P. H. Leenen
Ivar G. J. M. de Bruin
Publication date: 01-10-2021
Publisher: Springer Berlin Heidelberg
Keywords: Laparotomy
Blunt Abdominal Trauma
Laparotomy
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2021
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01313-4

At a glance: The STEP trials

Springer Medicine

Management of pediatric blunt abdominal trauma in a Dutch level one trauma center

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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