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Pediatric abdominal trauma

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https://www.readbyqxmd.com/read/29907210/nonoperative-management-of-penetrating-abdominal-solid-organ-injuries-in-children
#1
Reid Sakamoto, Kazuhide Matsushima, Amory de Roulet, Kristine Beetham, Aaron Strumwasser, Damon Clark, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Nonoperative management (NOM) of penetrating solid organ injuries (SOI) has not been well described in the pediatric population. The objective of this study was to characterize the epidemiology, injury patterns, and factors associated with trial and failure of NOM. METHODS: This is a retrospective cohort analysis of the National Trauma Data Bank for the period of 2007-2014. The study population included patients ≤18 y with penetrating injury to the liver, spleen, or kidney...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29848451/pediatric-golf-cart-trauma-not-par-for-the-course
#2
Brett M Tracy, Krista Miller, Ashley Thompson, Jo Cooke-Barber, Phillip Bloodworth, Eric Clayton, William Boswell
INTRODUCTION: Golf cart trauma in southeast Georgia represents a significant source of morbidity in the pediatric population. We believe these events are related to the introduction of new state legislation that allows local authorities to govern golf cart operation. METHODS: We performed a retrospective review from 2010 to 2016 of children involved in golf cart traumas (n = 46). We recorded age, gender, Glasgow Coma Scale score (GCS), Injury Severity Score (ISS), location of event, and patient position during event...
May 5, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29847540/patients-at-high-risk-of-intervention-for-pediatric-traumatic-liver-injury
#3
Katie A Donnelly, Kristen Breslin, Karen J OʼConnell
OBJECTIVES: Nonoperative management of hemodynamically stable liver lacerations in pediatric trauma patients is a safe and effective management strategy for pediatric patients; approximately 90% will be successfully managed nonoperatively. No study has specifically identified risk criteria for the need for intervention versus observation alone. Our objective for this study was to determine risk factors from the physical examination, computed tomography scan, and laboratory results associated with intervention for liver laceration...
May 25, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29843907/abdominal-stab-wound-injury-in-children-do-we-need-different-approach
#4
Alexander Becker, Kobi Peleg, Joseph Dubose, Yaakov Daskal, Adi Givon, Boris Kessel
BACKGROUND: Penetrating stab wounds in children are relatively rare and no clear recommendations for the optimal evaluation have been devised. An acceptable traditional approach to the patient with an abdominal stab wound who does not require urgent surgery is selective nonoperative management and serial exams. The use of routine computed tomography remains an actively utilized investigation for these patients at many institutions. PURPOSE: We hypothesize that the approach to pediatric stab wound victims should be distinctly different than that of adult counterparts in order to minimize radiation exposure...
May 5, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29692885/handlebar-hernia-in-children-a-conservative-approach-case-report-and-literature-review
#5
Maria Aggelidou, Savas Deftereos, Soultana Foutzitzi, Panagoula Oikonomou, Katerina Kambouri
Handlebar hernias are very rare and occur after a blunt abdominal trauma by a bicycle handlebar or a handlebar-shape object. As a result the abdominal wall musculature and fascia are disrupted while the skin is still intact. A good history of the injury and physical examination are usually enough to pose a diagnosis. We report the case of bicycle-handlebar hernia in a 6-year-old boy who presented to our emergency department because of a reducible swelling above the left iliac crest after falling from his bicycle 3 days ago...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29659473/external-validation-of-a-5-variable-clinical-prediction-rule-for-identifying-children-at-very-low-risk-for-intra-abdominal-injury-following-blunt-abdominal-trauma
#6
Chase A Arbra, Adam M Vogel, Leah Plumblee, Jingwen Zhang, Patrick D Mauldin, Melvin S Dassinger, Robert T Russell, Martin L Blakely, Christian J Streck
BACKGROUND: A clinical prediction rule was previously developed by the Pediatric Surgery Research Collaborative (PedSRC) to identify patients at very low risk for intra-abdominal injury (IAI) and intra-abdominal injury receiving an acute intervention (IAI-I) who could safely avoid abdominal computed tomography (CT) scans following blunt abdominal trauma (BAT). Our objective was to externally validate the rule. METHODS: The public use dataset was obtained from the Pediatric Emergency Care Applied Research Network (PECARN) Intra-abdominal Injury Study...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29651794/celiac-trunk-and-common-hepatic-artery-variations-in-children-an-analysis-with-ct-angiography
#7
Emine Caliskan, Turker Acar, Mehmet Ozturk, Zuhal Bayramoglu, Ravza Yilmaz, Filiz Elbuken, Ibrahim Adaletli
BACKGROUND: Understanding the celiac trunk and hepatic artery anatomy is important not only in preventing iatrogenic injuries but also in planning surgical procedures in children. Therefore, the aim of this study is to analyze the prevalence of celiac trunk (CeT) and common hepatic artery (CHA) variations in the pediatric population. MATERIALS AND METHODS: One hundred and seventy-four children (174) who underwent abdominal multidetector computed tomography (MDCT) angiography, either because of trauma or liver transplantation, were analyzed retrospectively...
April 13, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29644320/isolated-and-stable-gallbladder-perforation-in-a-5-year-old-child-after-blunt-abdominal-trauma
#8
I Issa, V Modica Alameddine, M C Fadous Khalife, M Al Ojaimi, Z Ghorayeb
Isolated gallbladder injury, secondary to a blunt abdominal trauma, is a rare finding in children. The presence of vague symptoms and the unknown dynamic of the trauma may increase the diagnostic challenge especially in pediatrics. A conservative management has been proposed in some particular cases in adults, but remains controversial in children. We report a case of a 5 year old boy who presented an isolated gallbladder lesion secondary to a blunt abdominal trauma. The surgical treatment was delayed for non-medical reasons, which gave us the possibility to try a conservative approach...
June 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29576401/longitudinal-analysis-of-hospital-charges-following-injury-in-a-level-1-pediatric-trauma-system
#9
Sean M Stokes, Eric R Scaife, Austin M Stevens, Stephen J Fenton
BACKGROUND: The treatment of injured children contributes substantially to the financial burden of a health care system. The purpose of this study was to characterize these charges at a level-1 pediatric trauma center. METHODS: Financial data for children (<14 years) admitted for traumatic injury from 1/2009 to 12/2014 were analyzed. The charges of the index admission and first two years following discharge were evaluated. RESULTS: 5853 trauma patients were included with average annual charges of $11,128,730...
February 25, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29557622/-acute-pancreatitis-secondary-to-an-abdominal-trauma-case-report-of-a-7-year-old-child
#10
Laura Montoya-Sánchez, Rocío Del P Pereira-Ospina, Javier Y Pinzón-Salamanca, José M Suescún-Vargas
Pancreatitis consists in acute inflammation of the pancreas that is clinically characterized by abdominal pain. To make the diagnosis it is necessary the elevation of biochemical markers like pancreatic amylase or lipase. It is the most frequent pancreatic disease in both children and adults. Its presentation in the pediatric population is increasing and has several etiologies such as: infections, trauma, intoxication and metabolic diseases. Trauma mechanisms have been described: child maltreatment, falls, trauma with the bicycle handle and traffic accidents...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29523358/injury-patterns-of-child-abuse-experience-of-two-level-1-pediatric-trauma-centers
#11
Yangyang R Yu, Annalyn S DeMello, Christopher S Greeley, Charles S Cox, Bindi J Naik-Mathuria, David E Wesson
PURPOSE: This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers. METHODS: We reviewed all children (<5years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries. RESULTS: Of 4623 trauma admissions, 557 (12%) were due to NAT...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29470319/splenic-rupture-in-children-with-portal-hypertension
#12
Orith Waisbourd-Zinman, Amit Shah, Henry C Lin, Elizabeth B Rand
INTRODUCTION: Massive splenomegaly from portal hypertension (PHTN) in children raises the specter of splenic rupture; however, the incidence, etiology, and risk of rupture have not been studied, nor have existing practices to reduce risk. We therefore performed an international survey to describe the splenic rupture cases in PHTN and to describe the existing empirical practice among hepatologists. METHODS: A questionnaire was constructed to elicit cases of splenic rupture and collect hepatologists' common practices for prevention of splenic rupture...
March 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29446794/migraine-variants-in-children
#13
A David Rothner
Migraine in children can manifest in ways that are markedly different from adult migraines. In children, migraine variants are often unaccompanied by headache and include conditions such as cyclic vomiting and abdominal migraine. Children who experience these conditions are often thought to have a disorder of the gastrointestinal tract, and when evaluation is unremarkable they may be diagnosed as having a conversion reaction. Complicated migraines, on the other hand, are often accompanied by focal neurological symptoms such as ataxia, hemiparesis, or altered level of consciousness that evoke great consternation in the examining clinician...
February 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29428102/liver-trauma-what-current-management
#14
Mohamed Tarchouli, Mohamed Elabsi, Noureddine Njoumi, Mohamed Essarghini, Mahjoub Echarrab, Mohamed Rachid Chkoff
BACKGROUND: The liver is the most commonly damaged organ in abdominal trauma. The management of liver trauma has experienced many changes over the last two decades. Currently there is a trend toward a non-operative treatment warranted by the successful pediatric experience and better results recorded in many trauma centers worldwide. This study aimed to evaluate outcomes of operative and non-operative management of liver trauma in our institution over the last five years. METHODS: The patients with a diagnosis of blunt or penetrating liver injuries, admitted and managed in our hospital from January 2012 to December 2016 were retrospectively studied...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29390566/clinical-features-and-outcomes-of-blunt-splenic-injury-in-children-a-retrospective-study-in-a-single-institution-in-china
#15
Kaiying Yang, Yanan Li, Chuan Wang, Bo Xiang, Siyuan Chen, Yi Ji
Although the spleen is the most commonly injured intra-abdominal organ after blunt trauma, there are limited data available in China. The objectives of this study were to investigate the clinical features and determine the risk factors for operative management (OM) in children with blunt splenic injury (BSI).A review of the medical records of children diagnosed with BSI between January 2010 and September 2016 at West China Hospital of Sichuan University was performed.A total of 101 patients diagnosed with BSI were recruited, including 76 patients transferred from other hospitals...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29367055/characterization-of-the-occult-nature-of-frequently-occurring-pediatric-motor-vehicle-crash-injuries
#16
Andrea N Doud, Samantha L Schoell, Jennifer W Talton, Ryan T Barnard, John K Petty, Joel D Stitzel, Ashley A Weaver
BACKGROUND: Occult injuries are those likely to be missed on initial assessment by first responders and, though initially asymptomatic, they may present suddenly and lead to rapid patient decompensation. No scoring systems to quantify the occultness of pediatric injuries have been established. Such a scoring system will be useful in the creation of an Advanced Automotive Crash Notification (AACN) system that assists first responders in making triage decisions following a motor vehicle crash (MVC)...
April 2018: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/29298250/accessory-spleen-fracture-report-of-a-pediatric-case-and-review-of-the-literature
#17
Eline Chauvet, Vasiliki Spyropoulou, Mehrak Anooshiravani-Dumont, Oliver Sanchez, Laurence Lacroix
Accessory spleen rupture may occur after blunt abdominal trauma or, more rarely, spontaneously. Although only few cases are described in adults, it is even more uncommon in children. We report the case of a 13-year-old boy with traumatic accessory spleen fracture. After a review of the literature, we discuss the diagnostic points that should raise the suspicion for accessory spleen fracture as well as how challenging the diagnosis by computed tomography can be.
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29283968/transfer-and-nontransfer-patients-in-isolated-low-grade-blunt-pediatric-solid-organ-injury-implications-for-regionalized-trauma-systems
#18
Robert A Tessler, Vivian H Lyons, Judith C Hagedorn, Monica S Vavilala, Adam Goldin, Saman Arbabi, Frederick P Rivara
BACKGROUND: Regionalization of trauma care is a national priority and hospitalization for blunt abdominal trauma, which may include transfer, is common among children. The objective of this study was to determine whether there were differences in mortality, treatment, or length of stay between patients treated at or transferred to a higher level trauma center and those not transferred and admitted to a lower level trauma center. METHODS: Cohort from Washington state trauma registry from 2000 to 2014 of patients 16 years or younger with isolated Grade I-III spleen, liver, or kidney injury...
April 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29230341/pancreatic-laceration-in-a-pediatric-patient-an-unexpected-diagnosis
#19
Michelle J Hong, Lauren M Porter, Debra D Esernio-Jenssen, Andrew C Miller, Marna Rayl Greenberg
Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29204237/pediatric-adrenal-trauma-evaluation-and-follow-up-with-contrast-enhanced-ultrasound-ceus
#20
Vasileios Rafailidis, Annamaria Deganello, Maria E Sellars, Erica Makin, Paul S Sidhu
Adrenal trauma is rarely encountered in the pediatric population, often as a component of multi-organ injury and often presenting with hematoma formation. Contrast-enhanced computed tomography (CECT) is the established imaging modality both for initial evaluation and follow-up of patients with blunt abdominal trauma. In children, radiation exposure should be minimized and alternative imaging strategies are needed. Contrast-enhanced ultrasound (CEUS) has recently been successfully used for evaluation of patients with hepatic, renal and splenic injury...
December 2017: Journal of Ultrasound
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