TRAUMA OF THE ABDOMINAL PARENCHYMATOUS ORGANS IN CHILDREN

Elena Ţarcă, Simona Gavrilescu, Bogdan Savu, Rosu Eduard, Tamara Solange Roşu

Abstract

Trauma of the abdominal parenchymatous organs is a major cause of morbidity and mortality in children, following craniocerebral, vertebro-medullary and thoracic trauma, which result primarily from car accidents, sports injuries, accidental falls impacting the abdominal region, physical aggressions and, particularly for newborn babies, obstetrical trauma. In order to highlight the repercussions of physical trauma on abdominal parenchymatous organs, we conducted a retrospective analytical study on patients admitted to and treated in the Pediatric Surgery Clinic of the “Sfânta Maria” Clinical Emergency Children’s Hospital in Iaşi over a period of approximately 2.5 years. Of a total 5,812 emergency admissions, 125 were for severe lesions of the abdominal parenchymatous organs. Of these patients, 8% underwent immediate or deferred surgery, which translated into three splenectomies, three surgical interventions for removing hepatic hematoma and hemoperitoneum, two interventions for renal ruptures, one hepatic suture and one drainage of a post-traumatic pancreatic pseudocyst. One of the interventions for hepatic hematoma drainage was performed in a newborn with obstetrical trauma. One of the multiple trauma patients that underwent splenectomy died 10 days after hospital admission, while postoperative evolution in the other patients was favorable, yet required extended hospital stay and repeated follow-ups. In conclusion, owing to the anatomic and physiological particularities of pediatric patients, any abdominal trauma in children can result in severe lesions of the parenchymatous organs, particularly affecting the liver and spleen, and with severe repercussions on the patient’s health status and even on their life.

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