TITLE

Injuries Associated with Pediatric Liver Trauma

AUTHOR(S)
Deluca, John A.; Maxwell, Damian R.; Flaherty, Sarah K.; Prigozen, Jason M.; Scragg, Mary E.; Stone, Patrick A.
PUB. DATE
January 2007
SOURCE
American Surgeon;Jan2007, Vol. 73 Issue 1, p37
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Injury remains the leading cause of childhood mortality for children younger than 14 years of age, with the liver being particularly susceptible to blunt trauma in children. This study reviews the authors' institutions' experience with pediatric liver injuries in an attempt to establish current patterns of injury, management and outcomes. A single-center, retrospective review was conducted of 105 consecutive pediatric patients who presented with a traumatic liver injury from January 1996 through February 2004. Average patient age was 13.1 ± 4.9 years and 58 per cent were male. Perihospital mortality was 8.6 per cent, with 67 per cent of mortality being attributed to head injury. The majority of patients were managed nonoperatively (81%l. Liver injury was most often grade II (35%) by CT scan. Liver injury grade did not affect survival, but did affect injury management, with grade I and grade IV liver injuries more likely to be managed surgically (P < 0.001). Grade I liver injuries were associated with concomitant spleen injuries, whereas grade IV injuries were associated with pancreatic injuries. Surgical management was associated with a higher injury severity score (P = 0.005), higher mortality (P = 0.01), and with other associated injuries as well. Children experiencing blunt abdominal trauma are at risk of significant morbidity and mortality; however, these risks stem more likely from associated injuries than injury to the liver proper. Clinicians should maintain a high index of suspicion for potentially catastrophic associated injuries to the pancreas with high-grade liver injury.
ACCESSION #
23655209

 

Related Articles

  • Non-Surgical Management of a Ruptured Posttraumatic Pancreatic Pseudocyst in a Child. Stavrou, G. A.; Fischer, R.; Kaczmarek, S.; Kirschstein, M.; Oldhafer, K. J. // Advances in Medical Sciences (De Gruyter Open);2008, Vol. 53 Issue 2, p331 

    Generally speaking, isolated pancreatic injuries are rare after abdominal blunt trauma. However, the incidence of pancreatic injuries in children has risen in recent decades. Panreatic pseudocyst represents a typical complication after acute pancreatitis due to blunt abdominal trauma....

  • Review of the evidence on the management of blunt renal trauma in pediatric patients. Fraser, Jason D.; Aguayo, Pablo; Ostlie, Daniel J.; Peter, Shawn D. St.; St Peter, Shawn D // Pediatric Surgery International;Feb2009, Vol. 25 Issue 2, p125 

    Due to the size and location within the pediatric patient, the kidneys are susceptible to injury from blunt trauma. While it is clear that the goal of management of blunt renal trauma in children is renal preservation, the methods of achieving this goal have not been well established in the...

  • Management of Major Blunt Liver Injury at Hartford Hospital: A Ten-Year Review. JACOBS, LENWORTH; BURNS, KARYL J.; GEORGAKIS, GEORGE // Connecticut Medicine;Mar2013, Vol. 77 Issue 3, p159 

    The purpose of this study was to describe the management of patients at Hartford Hospital with major blunt liver injuries. The medical records of patients admitted to Hartford Hospital between January 1, 2000 through January 31, 2010 with blunt trauma that resulted in a laceration with...

  • Blunt Trauma Injuries. DeBorardino, Thomas M. // Implicit Religion;Dec2012, Vol. 15 Issue 4, preceding p1 

    An introduction is presented in which the editor discusses various reports within the issue on topics including new medical technologies, blunt trauma of heart, lungs, and liver, and closed head injuries.

  • Validating the Functional Capacity Index as a measure of outcome following blunt multiple trauma. MacKenzie, E.J.; Sacco, W.J.; Luchter, S.; Ditunno, J.F.; Forrester Staz, C.; Gruen, G.S.; Marion, D.W.; Schwab, W.C.; Staz, C Forrester; Pennsylvania Study Group on Functional Outcomes Following Trauma // Quality of Life Research;Dec2002, Vol. 11 Issue 8, p797 

    Background: The validity of the Functional Capacity Index (FCI) is evaluated by examining its distributional characteristics, its correlation with other well-known measures of outcome and its ability to discriminate among persons with injuries of varying type and...

  • Are Serial Brain Imaging Scans Required for Children Who Have Suffered Acute Intracranial Injury Secondary to Blunt Head Trauma? Schnellinger, Mark G.; Reid, Samuel; Louie, Jeffrey // Clinical Pediatrics;Jun2010, Vol. 49 Issue 6, p569 

    In most instances, infants and children with moderate to severe head trauma undergo a head computed tomography (CT) scan as part of their initial evaluation. Several authors have advocated a routine second head CT after traumatic brain injury (TBI) to identify progressive lesions that may...

  • Can we abolish skull x rays for head injury? Reed, M. J.; Browning, J. G.; Wilkinson, A. G.; Beattie, T. // Archives of Disease in Childhood;Aug2005, Vol. 90 Issue 8, p859 

    Objectives: To assess the effect of a change in skull x ray policy on the rate of admission, use of computed tomography (CT), radiation dose per head injury, and detection of intracranial injuries; and to compare the characteristics of patients with normal and abnormal head CT. Design:...

  • Posttraumatic Chronic Ossified Extradural Hematoma: A Rare Case Report. Kumar, Rakesh; Mittal, Radhe Shyam // Romanian Neurosurgery;2014, Vol. 21 Issue 3, p363 

    Posttraumatic Chronic ossified extradural hematomas are rare entities. Natural absorption of EDH does not occurs due to calcification. Chronic ossified EDH is frequently present in paediatric age group. Careful regular follow-up is mandatory in conservatively managed case of EDH in children. We...

  • Blunt Trauma Evaluation and Management: Pitfalls to Avoid. Grossheim, Lisa Freeman; Bowman, Mary Jo // Emergency Medicine Reports;11/12/2007, Vol. 28 Issue 24, p1 

    This section discusses the caveats in the evaluation and management of blunt trauma patients in both the community hospital and trauma center. It is stated that patients with head injuries, substance abusers or those with distracting injuries are at highest risk for missed injuries. The spleen,...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics