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Abdominal Trauma

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Book cover Pediatric Surgery

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Abstract

Blunt abdominal trauma, largely made up of solid organ injury to the liver, spleen, and kidney, is a leading cause of injury-related hospitalization in any children’s hospital. The vast majority of hemodynamically stable children with major abdominal solid organ trauma can now be managed successfully by nonoperative treatment. A well-organized trauma response team in the emergency department is associated with a decreased time to CT and screening capabilities of focused sonography for trauma and thus increasing survival.

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References

  • Acker SN, et al. Pediatric specific shock index accurately identifies severely injured children. J Pediatr Surg. 2015;50:331; PMID: 25638631.

    Article  PubMed  Google Scholar 

  • Amirata E, Livingston DH, Elcavage J. Octreotide acetate decreases pancreatic complications after pancreatic trauma. Am J Surg. 1994;168:345; PMID: 7943592.

    Article  CAS  PubMed  Google Scholar 

  • Bansal S, et al. Contrast blush in pediatric blunt splenic trauma does not warrant the routine use of angiography and embolization. Am J Surg. 2015;210:345; PMID: 25827492.

    Article  PubMed  Google Scholar 

  • Beres AL, et al. Non-operative management of high-grade pancreatic trauma: is it worth the wait? J Pediatr Surg. 2013;48:1060; PMID: 23701783.

    Article  PubMed  Google Scholar 

  • Borkon MJ, et al. Operative intervention for complete pancreatic transection in children sustaining blunt abdominal trauma: revisiting an organ salvage technique. Am Surg. 2011;77:612; PMID: 21679597.

    Article  PubMed  Google Scholar 

  • Dabbs DN, Stein DM, Scalea TM. Major hepatic necrosis: a common complication after angioembolization for treatment of high-grade liver injuries. J Trauma. 2009;66:621; PMID: 19276729.

    Article  PubMed  Google Scholar 

  • Davies DA, et al. What’s the incidence of delayed splenic bleeding in children after blunt trauma? An institutional experience and review of the literature. J Trauma. 2009;67:573; PMID: 19741402.

    Article  PubMed  Google Scholar 

  • Davies DA, et al. What is the significance of contrast "blush" in pediatric blunt splenic trauma? J Pediatr Surg. 2010;45:916; PMID: 20438926.

    Article  PubMed  Google Scholar 

  • Durkin N, et al. Post-traumatic liver and splenic pseudoaneurysms in children: diagnosis, management, and follow-up screening using contrast enhanced ultrasound (CEUS). J Pediatr Surg. 2015;51(2):289–92; PMID: 26656617.

    Article  PubMed  Google Scholar 

  • Fisher JC, et al. Central pancreatectomy with pancreaticogastrostomy in children. J Pediatr Surg. 2007;42:740; PMID: 17448780.

    Article  PubMed  Google Scholar 

  • Gaines BA. Intra-abdominal solid organ injury in children: diagnosis and treatment. J Trauma. 2009;67:S135; PMID: 19667846.

    Article  PubMed  Google Scholar 

  • Gates RL, Price M, Cameron DB, et al. Non-operative management of solid organ injuries in children: an American Pediatric Surgical Association outcomes and evidence based practice committee systematic review. J Pediatr Surg. 2019;54(8):1519–26.

    Article  PubMed  Google Scholar 

  • Gross JL, et al. Embolization for pediatric blunt splenic injury is an alternative to splenectomy when observation fails. J Trauma Acute Care Surg. 2013;75:421; PMID: 23928740.

    Article  PubMed  Google Scholar 

  • Haugaard MV, et al. Non-operative versus operative treatment for blunt pancreatic trauma in children. Cochrane Database Syst Rev. 2014;2:CD009746; PMID: 24523209.

    Google Scholar 

  • Herman R, Guire KE, Burd RS, et al. Utility of amylase and lipase as predictors of grade of injury or outcomes in pediatric patients with pancreatic trauma. J Pediatr Surg. 2011;46:923.

    Article  PubMed  Google Scholar 

  • Holmes JH, et al. The failure of nonoperative management in pediatric solid organ injury: a multi-institutional experience. J Trauma. 2005;59:1309; PMID: 16394902.

    Article  PubMed  Google Scholar 

  • Houben CH, et al. Traumatic pancreatic duct injury in children: minimally invasive approach to management. J Pediatr Surg. 2007;42:629; PMID: 17448757.

    Article  PubMed  Google Scholar 

  • Iacono C, et al. Systematic review of central pancreatectomy and meta-analysis of central versus distal pancreatectomy. Br J Surg. 2013;100:873; PMID: 23640664.

    Article  CAS  PubMed  Google Scholar 

  • Iqbal CW, Levy SM, Tsao K, Petrosyan M, Kane TD, Pontarelli EM, Upperman JS, Malek M, Burns RC, Hill S, Wulkan ML, St Peter SD. Laparoscopic versus open distal pancreatectomy in the management of traumatic pancreatic disruption. J Laparoendosc Adv Surg Tech A. 2012;22(6):595–8.

    Article  PubMed  Google Scholar 

  • Iqbal CW, et al. Operative vs nonoperative management for blunt pancreatic transection in children: multi-institutional outcomes. J Am Coll Surg. 2014;218:157; PMID: 24440062.

    Article  PubMed  Google Scholar 

  • Keil R, et al. What is the role of endoscopic retrograde cholangiopancreatography in assessing traumatic rupture of the pancreatic in children? Scand J Gastroenterol. 2016;51:218; PMID: 26200695.

    Article  PubMed  Google Scholar 

  • Lee J, Moriarty KP, Tashjian DB. Less is more: management of pediatric splenic injury. Arch Surg. 2012;147:437; PMID: 22785639.

    PubMed  Google Scholar 

  • Letton RW, Worrell V, APSA Committee on Trauma Blunt Intestinal Injury Study Group. Delay in diagnosis and treatment of blunt intestinal injury does not adversely affect prognosis in the pediatric trauma patient. J Pediatr Surg. 2010;45:161; PMID: 20105598.

    Article  PubMed  Google Scholar 

  • Lutz N, Nance ML, Kallan MJ, et al. Incidence and clinical significance of abdominal wall bruising in restrained children involved in motor vehicle crashes. J Pediatr Surg. 2004;39:972–5.

    Article  PubMed  Google Scholar 

  • Mattix KD, et al. Pediatric pancreatic trauma: predictors of nonoperative management failure and associated outcomes. J Pediatr Surg. 2007;42:340; PMID: 17270545.

    Article  PubMed  Google Scholar 

  • Mayglothling JA, Haan JM, Scalea TM. Blunt splenic injuries in the adolescent trauma population: the role of angiography and embolization. J Emerg Med. 2011;41:21; PMID: 19181474.

    Article  PubMed  Google Scholar 

  • McVay MR, et al. Throwing out the “grade” book: management of isolated spleen and liver injury based on hemodynamic status. J Pediatr Surg. 2008;43:1072; PMID: 18558185.

    Article  PubMed  Google Scholar 

  • Miele V, et al. Contrast-enhanced ultrasound (CEUS) in blunt abdominal trauma. Br J Radiol. 2015;89:20150823. PMID: 26607647.

    Article  Google Scholar 

  • Moore EE, Cogbill TH, Malangoni MH, et al. Organ injury scaling. II Pancreas, duodenum, smallbowel, colon and rectum. J Trauma. 1990;30:1427–9.

    Article  CAS  PubMed  Google Scholar 

  • Nance ML, Holmes JH, Wiebe DJ. Timeline to operative intervention for solid organ injuries in children. J Trauma. 2006;61:1389; PMID: 17159681.

    Article  PubMed  Google Scholar 

  • Nikfarjam M, Rosen M, Ponsky T. Early management of traumatic pancreatic transection by spleen-preserving laparoscopic distal pancreatectomy. J Pediatr Surg. 2009;44:455; PMID: 19231557.

    Article  PubMed  Google Scholar 

  • Notrica DM, et al. Nonoperative management of blunt liver and spleen injury in children: evaluation of the ATOMAC guideline using GRADE. J Trauma Acute Care Surg. 2015;79:683; PMID: 26402546.

    Article  PubMed  Google Scholar 

  • Nti BK, Laniewicz M, Skaggs T, et al. A novel streamlined trauma response team training improves imaging efficiency for pediatric blunt abdominal trauma patients. J Pediatr Surg. 2019;54(9):1854–60.

    Article  PubMed  Google Scholar 

  • Paul MD, Mooney DP. The management of pancreatic injuries in children: operate or observe. J Pediatr Surg. 2011;46:1140; PMID: 21683212.

    Article  PubMed  Google Scholar 

  • Polites SF, et al. Benchmarks for splenectomy in pediatric trauma: how are we doing? J Pediatr Surg. 2015;50:339; PMID: 25638633.

    Article  PubMed  Google Scholar 

  • Rodríguez JR, et al. Distal pancreatectomy with splenic preservation revisited. Surgery. 2007;141:619; PMID: 17462461.

    Article  PubMed  Google Scholar 

  • Russell KW, et al. Non-operative treatment versus percutaneous drainage of pancreatic pseudocysts in children. Pediatr Surg Int. 2013;29:305; PMID: 23274700.

    Article  CAS  PubMed  Google Scholar 

  • Rutkoski JD, Segura BJ, Kane TD. Experience with totally laparoscopic distal pancreatectomy with splenic preservation for pediatric trauma–2 techniques. J Pediatr Surg. 2011;46:588; PMID: 21376217.

    Article  PubMed  Google Scholar 

  • Safavi A, et al. Traumatic pseudoaneurysms of the liver and spleen in children: is routine screening warranted? J Pediatr Surg. 2011;46:938; PMID: 21616256.

    Article  PubMed  Google Scholar 

  • Soukup ES, et al. Treatment and outcome of traumatic biliary injuries in children. J Pediatr Surg. 2014;49:345; PMID: 24528983.

    Article  PubMed  Google Scholar 

  • St Peter SD, et al. Follow up of prospective validation of an abbreviated bedrest protocol in the management of blunt spleen and liver injury in children. J Pediatr Surg. 2013;48:2437; PMID: 24314183.

    Article  PubMed  Google Scholar 

  • Stylianos S. Abdominal packing for severe hemorrhage. J Pediatr Surg. 1998;33:339; PMID: 9498413.

    Article  CAS  PubMed  Google Scholar 

  • Stylianos S. Evidence-based guidelines for resource utilization in children with isolated spleen or liver injury. The APSA Trauma Committee. J Pediatr Surg. 2000;35:164; PMID: 10693659.

    Article  CAS  PubMed  Google Scholar 

  • Stylianos S. Compliance with evidence-based guidelines in children with isolated spleen or liver injury: a prospective study. J Pediatr Surg. 2002;37:453; PMID: 11877665.

    Article  PubMed  Google Scholar 

  • Stylianos S. To save a child’s spleen: 50 years from Toronto to ATOMAC. J Pediatr Surg. 2019;54(1):9–15.

    Article  PubMed  Google Scholar 

  • Stylianos S, et al. Variation in treatment of pediatric spleen injury at trauma centers versus nontrauma centers: a call for dissemination of American Pediatric Surgical Association benchmarks and guidelines. J Am Coll Surg. 2006;202:247; PMID: 16427549.

    Article  PubMed  Google Scholar 

  • van der Vlies CH, et al. The failure rate of nonoperative management in children with splenic or liver injury with contrast blush on computed tomography: a systematic review. J Pediatr Surg. 2010;45:1044; PMID: 20438952.

    Article  PubMed  Google Scholar 

  • Wales PW, Shuckett B, Kim PC. Long-term outcome after nonoperative management of complete traumatic pancreatic transection in children. J Pediatr Surg. 2001;36:823; PMID: 11329598.

    Article  CAS  PubMed  Google Scholar 

  • Wood JH, et al. Operative vs nonoperative management of blunt pancreatic trauma in children. J Pediatr Surg. 2010;45:401; PMID: 20152361.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Morgan Stanley Children’s Hospital, New York, NY, USA

    Steven Stylianos

  2. The State University of New York at Buffalo, Buffalo, NY, USA

    Katherine Bass

  3. Children’s Hospital of San Antonio, San Antonio, TX, USA

    Barry Cofer

  4. Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Barbara Gaines

  5. Nemours Children’s Specialty Care, Jacksonville, FL, USA

    Robert Letton

Authors
  1. Steven Stylianos
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  2. Katherine Bass
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  3. Barry Cofer
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  4. Barbara Gaines
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  5. Robert Letton
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Corresponding author

Correspondence to Steven Stylianos .

Editor information

Editors and Affiliations

  1. Our Lady’s Children's Hospital, National Children’s Research Centre, Dublin, Ireland

    Prem Puri

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Stylianos, S., Bass, K., Cofer, B., Gaines, B., Letton, R. (2020). Abdominal Trauma. In: Puri, P. (eds) Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38482-0_140-1

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  • DOI: https://doi.org/10.1007/978-3-642-38482-0_140-1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38482-0

  • Online ISBN: 978-3-642-38482-0

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