Liver injuries in children: The role of selective non-operative management
Keywords:
Children, Liver traumaAbstract
Background: Trauma remains the leading cause of mortality in the pediatric population. Liver injuries occur commonly in blunt abdominal trauma.Aim: To assess the selective non-operative management of liver injuries in children.
Methods: A retrospective review of 51patients with a discharge diagnosis of traumatic liver injuries at Tunis Children’s Hospital, over a 14-year period from 1996 to 2009.
Results:We identified 51 patients with liver trauma. The median age was 7 years. Boys accounted for 58% (n= 30), and the most common cause was traffic accident. Head injuries were the most common associated injuries. Forty-nine patients (96%) required non-operative management without complications. The mean in-hospital stay was 10 days in this group. The ultrasound demonstrated complete resolution and healing after 3-6 months. Two patients underwent surgery for hemodynamic instablity. The mortality rate was 0.2 %
Conclusion: Safe, non-operative management involves careful serial examination, a CT scanning facility and close monitoring of the patient in a fully equipped high-dependency unit with trained staff to run it. Even though most patients can be treated non-operatively the challenge is to identify the severely injured child early and institute aggressive resuscitation and expedite laparotomy.
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