SOLID ORGAN INJURIES IN BLUNT ABDOMINAL TRAUMA IN CHILDREN

Abstract

INTRODUCTION: Trauma has come to occupy a prominent position as one of the preventable cause of death children.
In developed countries trauma to the abdomen is mainly due to road traffic accidents. Abdomen is the third most
commonly injured part of the body next to injuries to extremities and head injuries in children. Blunt injury to the
abdomen causes single organ injury or multiple organ injury according to the severity of the accident.
AIM OF THE STUDY: To evaluate the impact of blunt abdominal trauma on various intra abdominal solid organs such as
liver, spleen, pancreas and kidney with regard to age, sex and various modes of blunt injuries. To evaluate various
associated injuries occurring in blunt abdominal trauma. To evaluate the value of various available investigations
employed for the diagnosis of the solid organ injuries in blunt abdominal trauma. To analyse the various modalities of
treatment available for solid organ injuries. To compare the incidence and mode of injuries due to agricultural and
agricultural related activities with that of road traffic accidents.
MATERIAL AND METHODS: Forty five children of blunt abdominal trauma with solid organ injuries admitted in our
hospital during the period of July 2015 to June 2019 were taken for this study. The clinical features were studied in detail
with special note to any associated injuries like head injury, chest injury and fracture limbs. Plain X-Ray of the abdomen,
Ultra sonogram of abdomen, intravenous urogram and CAT scan abdomen were done in relevant cases. Laparotomy was
done except when conservative management was planned.
OBSERVATION: In our study of forty five patients, solid organ injuries confirmed clinically in thirty four patients, by
ultrasonogram in nine patients and by postmortem finding in two patients. In this study, the number of splenic injuries
was twenty, liver injuries were fourteen, pancreatic injuries were eight and renal injuries were three. Injury due to road
traffic accidents was the cause in twenty five cases, injury during agricultural activities was seventeen and injury due to
fall from height was the cause in three cases.
CONCLUSION: The commonest intra abdominal organ injured was spleen followed by liver pancreas and kidney. The
commonest associated injury was chest injury followed by injury to the extremities. Biochemical investigations are not
very useful in the diagnosis of specific intra abdominal organ injury. Imaging studies like x- ray, ultrasonogram and CT
scan are only complimentary to clinical diagnosis. In the management, conservation procedures are better advocated
for minor injuries. Injury occurring during agricultural and related activities is more in this region due to agricultural
nature of this part of Tamilnadu.