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Management of intra-abdominal organ injury following blunt abdominal trauma in children.

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Rossi, D de Ville de Goyet, J Clément de Cléty, S Wese, François-Xavier [UCL] Veyckemans, Francis [UCL] Clapuyt, Philippe [UCL] Moulin, Didier [UCL]

OBJECTIVE: To evaluate the strategy of a combined diagnostic and therapeutic approach in children with intra-abdominal organ injury following blunt abdominal trauma. DESIGN: Retrospective clinical study. SETTING: Pediatric intensive care unit of an university hospital. PATIENTS: 38 children with documented intra-abdominal injury. INTERVENTION: Initial non-surgical treatment by a team of pediatric intensivists, radiologists and surgeons. MEASUREMENTS AND RESULTS: Physical examination, oriented blood and urine tests, plain abdominal film, abdominal ultrasound (US) and computed tomography (CT) with contrast. US documented intra-abdominal fluid in 30 and initial organ lesion in 14 out of 31 patients evaluated. Abdominal CT demonstrated the precise organ lesion in 34 out of 36 patients examined with solid organ lesion. Early laparotomy was needed in 7 because of severe shock, pneumoperitoneum and ruptured diaphragm, and delayed surgery in 6 patients. All 38 patients regained a normal life. CONCLUSIONS: The stepped diagnostic approach combined with initial non-surgical treatment by a team provided accurate diagnosis and appropriate treatment. Abdominal US, by demonstrating free intra-abdominal fluid is very sensitive to detect patients with intra-abdominal organ injury, CT scan with contrast is needed to give precise information of specific organ lesions.

Document type Article de périodique (Journal article) – Journal Article
Access type Accès restreint
Publication date 1993
Journal information "Intensive care medicine" - Vol. 19, no. 7, p. 415-9 (1993)
Peer reviewed yes
issn 0342-4642
Publication status Publié
Affiliations UCL - MD/CHIR - Département de chirurgie
UCL - MD/RAIM - Département de radiologie et d'imagerie médicale
UCL - MD/GYPE - Département de gynécologie, d'obstétrique et de pédiatrie
MESH Subject Abdominal Injuries - radiography - therapy - ultrasonography ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Intensive Care - methods ; Intensive Care Units, Pediatric ; Male ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating - radiography - therapy - ultrasonography
Links
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Bibliographic reference Rossi, D ; de Ville de Goyet, J ; Clément de Cléty, S ; Wese, François-Xavier ; Veyckemans, Francis ; et. al. Management of intra-abdominal organ injury following blunt abdominal trauma in children.. In: Intensive care medicine, Vol. 19, no. 7, p. 415-9 (1993)
Permanent URL http://hdl.handle.net/2078.1/13603