Management of pediatric blunt abdominal trauma in resource-restricted settings: a cross-sectional study

Abstract

Introduction: Management of pediatric blunt abdominal trauma in resource-restricted settings requires precise clinical expertise. In this study, we reviewed pediatric patients who were suspected to have blunt abdominal trauma in a level III trauma center in Iran. Materials and Methods: In a cross-sectional study, 66 injured children were studied from October 01, 2014 to October 01, 2015 in Nikshahr, Sistan-va-Balouchestan, Iran. Patient characteristics, type of trauma, initial evaluation and final decisions were analyzed. Results: Mean age was 8.2 ± 13.3 years. Thirty five patients (53%) were boys and 31 patients (47%) were girls. Focused Assessment with Sonography for Trauma (FAST) was done for all patients. Diagnostic Peritoneal Lavage (DPL) was done on five patients (7.6%). Laparatomy was conducted on seven patients (10.6%). Ten patients (15.2%) were referred to a higher level trauma center. There were three mortalities (4.5%). Positive FAST was associated with hemodynamic instability (p<0.05) and the need for laparatomy (p<0.05). Positive FAST was also associated with more admission days (5.9 ± 5.1 days versus 2.1 ± 2.6 days; p<0.05). There was also a significant relationship between the length of hospital stay and associated traumas (p<0.001). Conclusion: Computed tomography and intensive care unit may be unavailable in resource restricted settings with level III and IV trauma centers. However, physical examination, FAST and DPL are useful diagnostic tools for assessment of injured children with blunt abdominal trauma.

Keywords

• abdominal trauma
• blunt trauma
• pediatric trauma
• laparatomy