Conservative Management of Blunt Abdominal Trauma in Paediatric Population – An Experience in Interior Sindh

Abstract

Objective: To evaluate the management of blunt intra-abdominal trauma in the paediatric population
Methodology: Between May 2019 and May 2020, a 12-month prospective observational study was conducted in the departments of Paediatric Surgery at Ghulam Muhammad Mahar Medical College, Sukkur and Shaheed Mohtarma Benazir Bhutto Medical University, Larkana. All children under the age of 18 years presenting with blunt abdominal trauma at our set up, irrespective of the cause of injury, were included in the study. Those who presented with polytrauma, hollow viscus injury, and older than 18 years were not included in
the study.
Results: A total of 1,459 patients with trauma presented out of whom 90 (6.1%) were diagnosed with abdominal trauma. The majority of the patients were male i.e. 70 (77.77%). The mortality rate was 10%. Spleen was the most frequently wounded organ in 50 (55.5%) patients followed by liver injury in 30 (33.3%) patients and trauma to the kidney in 10 cases (11.1%). It was found that the higher the grade or more severe the organ injury, the poorer the prognosis of the patient. Fluid resuscitation or blood transfusion were necessary in the majority of patients with grade IV and V organ damage. Similarly, mortality rate was higher in patients with grade III, IV, and V injuries.
Conclusion: Satisfactory results were achieved in the paediatric population managed conservatively for blunt abdominal trauma. Further studies need to be conducted in order to determine the management in Grade V injuries.