Aim of the Study:
Penetrating injuries account for 10% to 20% of all pediatric trauma admissions at most centers. The aim of our study was to determine the impact of imaging on the surgical conduct in penetrating
abdominal and pelvic injuries in childhood
Methods:
Six children aged 2 – 13 years, referred to our hospital during a two-year period due to abdominal and pelvic penetrating injuries. Causes of injuries were: Gunshot wound – 1 case, Knife – 1, Pencil – 2, Metal rod – 1, Wooden rod – 1.
The children were evaluated in the ER and since they were considered hemodynamically stable,
they underwent radiological evaluation.
All 6 patients underwent CT Scans, 2 underwent a gastrointestinal enema, one an upper
gastrointestinal examination and another a cystography.
Main Results:
The utility of imaging assisted the surgeon with the identification of organ injury, visualization of the
penetrating device and its relation to anatomic structures. It was also important for the
diagnosis of bleeding, extravasation, pneumoperitoneum and pneumothorax.
In our 6 patients, 1 patient underwent laparotomy, a colostomy was avoided in one patient,
and 2 pencils and 1 knife were removed without major surgery.
Conclusions:
- The correct use of imaging modalities helps the surgeon decide the best surgical approach
and may prevent unnecessary surgery such as colostomy or explorative laparotomy.
- Do not remove foreign body before imaging and surgery – its presence may be helpful for the diagnosis, and there may be danger in removal.
- The imaging modalities and their sequence should be decided by the surgeon
and the radiologist together.
