hrvatski

Tupe ozljede trbuha u adolescenata - Multidisclipinarni pristup

Blunt abdominal trauma is the major cause of abdominal injury in adolescents and children. Five percent of all injuries in children are constituted by blunt abdominal trauma. Vehicle accidents, falls and blows in the abdomen are the most common cause of blunt abdominal trauma. Multidisciplinary approach in adolescents is essential for treatment of these patients and includes many specialist i.e. pediatric surgeon, anesthesiologist, pediatrics and neurosurgeon. The case records of 31 patients (26 male, 5 female) treated for blunt abdominal injury in the department of pediatric surgery, University Hospital Split, from January 2003 trough December 2009 were reviewed. Mean age was 15.5 years. Twenty-six patients were diagnosed associated injuries, and 5 patients only had abdominal injury. Seventeen patients had a spleen injury, 12 patients had urinary tract injury, 4 patients had a liver injury, 3 patients had a bowel injury, 2 patients had a mesenteric blood vessels injury and 1 patient had a pancreatic injury. Twenty of the patients were managed non-operatively and in 11 patients a surgery was performed. The abdominal trauma was diagnosed using a combination of clinical, biochemical, and radiological examinations (ultrasonography, computed tomography, arteriography and intravenous urography). Average hospitalization time was 18.7 days. All patients made complete recovery, except two patients who died due to associated injuries. In conclusion, abdominal organ injuries as a result of blunt abdominal trauma are very complex and often associated with injuries of other organ systems. We have to treat patients with solid organ injuries conservatively, whenever is possible, and in case of surgery we have to be minimally invasive.

abdominal blunt trauma; abdominal injury; adolescent; blood vessel injury; clinical article; clinical assessment; clinical feature; computer assisted tomography; conference paper; conservative treatment; convalescence; death; echography; female; hospitalization; human; intestine injury; intravenous urography; medical record review; mesentery blood vessel; organ injury; pancreas injury; pediatric surgery; radiodiagnosis; spleen injury; traffic accident; urinary tract injury...

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