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Solid Organ trauma an Offally good approach. Juliette King Department Paediatric surgery Starship. Haggis. Background. 1/1/09-31/12/2013. 146 patients identified from the prospectively managed trauma database. 10 excluded as did not have injury of Liver, Spleen, Kidney, Pancreas.
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Solid Organ trauma an Offally good approach Juliette King Department Paediatric surgery Starship
1/1/09-31/12/2013 • 146 patients identified from the prospectively managed trauma database. • 10 excluded as did not have injury of Liver, Spleen, Kidney, Pancreas. • 44% were direct admissions the rest transferred in
Demographics • Age Mean 9 (1-15) • Sex 74% Male • 3 deaths from other injuries
Tests • Elevated transaminases • Decreased haemaglobin • Micro or macroscopic haematuria • Elevated amylase
Signs and symptoms • Handlebar marks • Bruises over flanks • Unconscious patient • Abdominal tenderness • Seat belt marks • Chest or pelvic injury
AAST Grading Liver http://www.aast.org/library/traumatools/injuryscoringscales.aspx
Conclusion • Solid organ trauma is common and can have fairly benign seeming mechanisms of injury. • If they are suspected contrast enhanced CT is the imaging of choice • They can usually be managed conservatively following grading by CT • We are still very conservative in our management. • We are looking to creating a guideline for in patient stay.
References • Hynick et al 2013 J Trauma AcuteCareSurgVolume 76, Number 1 • Stylianos Journal of Pediatric Surgery, Vol 35, No 2 (February), 2000: pp 164-169 • Aguyau et al Journal of Pediatric Surgery (2010) 45, 1311–1314 • Leinwand et al Journal of Pediatric Surgery, Vol 39, No 3 (March), 2004: pp 487-490 • St Peter et al Journal of Pediatric Surgery (2013) 48, 2437–2441 • Yang et al Journal of Pediatric Surgery (2008) 43, 2264–2267