PAEDIATRIC BLUNT ABDOMINOPERINEAL INJURIES SUCCESSFULLY MANAGED - CASE SERIES

Abstract

Trauma is an important cause of mortality and morbidity in children. Abdominal trauma is the 3rd leading cause of trauma death. Abdominal injuries can have a varied presentation. The first case was a 2 years old male child with gastric perforation and fracture shaft of tibia due to fall of a gas cylinder on him. Laparotomy showed a huge rent in the stomach which was closed after thorough lavage. POP cast was applied for the fracture tibia. Child recovered well and is on follow up. The second case was a 2 year old female admitted with the history of fall of a Television on the abdomen. Investigations revealed features of bowel injury .Laparotomy revealed a rent in the second part of the duodenum, which was closed primarily. The child recovered well and is on follow up. Third case was a 3 year old female child with split perineum and open book fracture of the pelvis due run over by a bus. The patient was treated with reconstruction of the entire perineum along with colostomy, suprapubic cystostomy and external fixation of the pelvis. This child is able to walk normally and continent of urine and feces. Fourth case was a 5 year old boy was admitted with severe injuries to the perineum and lower abdomen along with amputation of the right lower limb below the mid-thigh level with shock.After stabilisation, he was treated with Laparotomy and colostomy .The perineal reconstruction done Pelvic bones were stabilised with external fixators and right mid-thigh amputation was done by the Orthopaedic team. The colostomy closure was done.Now the wounds have healed well and the child is continent. These cases are a small sample of the varied presentation that abdominal trauma can have and with aggressive management morbidity and mortality rates can be reduced.