Paediatric Abdominal Trauma: Variety of Trauma Mechanisms, Resulting Injuries and Treatment

The study concentrated on data related to trauma mechanism in children (n=134) with blunt abdominal trauma like clinical findings, affected organs, results of radiologic imaging and clinical outcome. Points of interest were patient´s age and sex, time and season of accident, mechanism of injury, involved objects, severity of injuries, treatment and complications. Accident mechanisms varied depending on age and male patients had higher severe grades of injury pattern (p=0.008). Boys are more often (in 67,9%) involved to suffer an intraabdominal injury (IAI) with severe grades of injury pattern (p=0.014). Depending on age, proportions of various accident mechanisms occurred. Leading trauma was in 56% a fall, most common less than 1meter, followed by sport related trauma (41,8%) and road traffic accidents (21.6%). In children with abnormal laboratory studies the grade injury pattern was more severe (p<0,001). Focused Assessment with Sonography for Trauma (FAST) was primary performed in 85,8% and correlation between free abdominal fluid and injury pattern was significant (p<0.001). 41,8% had an IAI with organ laceration and 46,3% had additionally injuries like head or thorax trauma. Conservative treatment of IAI was performed in 60,7% (n=34) and invasive treatment with abdominal surgery in 39,2% (n=22). Complications occurred in 34.4%, significantly after spleen (p=0.001), liver (p=0,001) and GI-tract injuries (p=0,001). Hospital duration stay increased with severity of injury (p<0.001), especially after child abuse. Despite rarity of massive IAI after child abuse, it is vital for the affected children that involved medical staff kept this potential trauma issue in mind. We showed that risks for suffering severe IAI are present even during everyday activities, not just in traffic accidents. Focus should be on prevention on risk children, adapted to their age and danger potential. Parents have to be enlightened about risks directly and should train their children to perceive them.