Isolated and multisystem hepatic trauma in children: the true role of non-operative management.
Pediatr Surg Int
; 18(2-3): 98-103, 2002 Mar.
Article
en En
| MEDLINE
| ID: mdl-11956771
We retrospectively reviewed children with hepatic injuries (HI) admitted to our institutions from January 1982 to December 1999. Specific comparison was made of isolated (IHT) and multisystem hepatic trauma (MHT). Over the 18-year period 127 patients were identified with HI, 91 (71%) with MHT and 36 with IHT. The median age was 8 years (range 13 months to 14 years). Motor vehicle injury was the most common mechanism in both groups, but bicycle injuries were more common in IHT ( P<0.001). Shock ( P=0.02), the requirement for blood transfusion ( P<0.001), and operative intervention for the HI ( P=0.001) were all significantly more common in MHT. The distribution of liver injury grades was similar between the two groups. Twenty-two (17.3%) children died and in 18 the HI was the main cause or contributed significantly. There were 19 and 3 deaths in the MHT and IHT groups, respectively, a difference that was not significant. After excluding children with minor HI, 27 (39%) required operative intervention within 24 h of their injury. This suggests that the high success rate for non-operative management of HIs in the literature may have been biased by the inclusion of a significant proportion of subclinical injuries.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Traumatismo Múltiple
/
Hígado
Tipo de estudio:
Etiology_studies
Límite:
Adolescent
/
Child
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Child, preschool
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Female
/
Humans
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Infant
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Male
Idioma:
En
Revista:
Pediatr Surg Int
Asunto de la revista:
PEDIATRIA
Año:
2002
Tipo del documento:
Article
País de afiliación:
Australia
Pais de publicación:
Alemania