Paediatric and adolescent traumatic gastrointestinal injuries: results of a European multicentre analysis
Makaleler > Tam Makale · 2013
Yazarlar: E. E. Fischerauer, S. Zoetsch, C CAPİTO, A BONNARD, S. Sarkoezy, J BERNDT, S HOSİE, R. Beltra Pico, G STEİNAU, A WİEJEK, P CZAUDERNA, Ahmet ÇELİK, A. Lain Fernandez, V. M. Ibanez, C ESPOSİTO, A. K. Saxena
Acta Paediatrica, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2013, cilt 102, ss 977-981
DOI: 10.1111/apa.12337
Özet
AIM: Paediatric gastrointestinal injuries (GIIs) are rare, and the aim of this multicentre study was to evaluate their outcomes in a large cohort. METHODS: Hospital databases of 10 European paediatric surgical centres were reviewed for paediatric traumatic GIIs managed between 2000-2010. RESULTS: Ninety-seven patients with a median age of 9 years (0-17 years) were identified, with 72 blunt and 25 penetrating GIIs. Initial diagnostics in 90 patients led to correct diagnosis in 71%. Diagnostics were delayed in 26 patients (median 24 h). Eighty-two patients required surgery (67 laparotomy, 12 laparoscopy and three other approaches). There was a 50% conversion in the laparoscopic group. Median hospital stay was 10 days (range 1-137 days), with longer duration influenced by associated injuries (n = 41). Diagnosis <24 h was associated with significantly shorter hospital stay compared to more than 24 h (p = 0.011). In one-third of patients, morbidities were not related to a diagnostic delay or type of injury. There were five lethal outcomes, four due to associated injuries. CONCLUSION: Initial diagnostics in traumatic paediatric GIIs provide false negatives in one-third of patients. Diagnostic delay <24 h is associated with a significantly shorter hospital stay. Although laparoscopy is associated with a conversion rate of 50%, it can be used for diagnosis in suspected cases to avoid nontherapeutic laparotomy.