Citation

Fischerauer EE, Zötsch S, Capito C, Bonnard A, Sárközy S, Berndt J, Hosie S, Pico RB, Steinau G, Wiejek A, Czauderna P, Celik A, Fernandez AL, Ibanez V, Esposito C, Saxena A. Acta Paediatr. 2013; 102(10): 977-981.

Affiliation

Department of Pediatric- and Adolescent Surgery, Medical University of Graz, Graz, Austria.

Copyright

(Copyright © 2013, John Wiley and Sons)

DOI

10.1111/apa.12337

PMID

23815746

Abstract

AIM: Paediatric gastrointestinal injuries (GIIs) are rare and the aim of this multicentre study was to evaluate their outcomes in a large cohort.

METHODS: Hospital databases of 10 European paediatric surgical centres were reviewed for paediatric traumatic GIIs managed between 2000-2010.

RESULTS: Ninety-seven patients with a median age of nine years (0-17 years) were identified, with 72 blunt and 25 penetrating GIIs. Initial diagnostics in 90 patients led to correct diagnosis in 71%. Diagnostics were delayed in 26 patients (median 24h). Eighty-two patients required surgery (67 laparotomy, 12 laparoscopy and three other approaches). There was a 50% conversion in the laparoscopic group. Median hospital stay was 10 days (range 1-137d), with longer duration influenced by associated injuries (n=41). Diagnosis ≤24h was associated with significantly shorter hospital stay compared to >24 hours (p 0.011). In one-third of patients, morbidities were not related to a diagnostic delay or type of injury. There were five lethal outcomes, four due to associated injuries.

CONCLUSION: Initial diagnostics in traumatic paediatric GIIs provide false negatives in one-third of patients. Diagnostic delay ≤ 24h is associated with a significantly shorter hospital stay. Although laparoscopy is associated with a conversion rate of 50%, it can be used for diagnosis in suspected cases to avoid non-therapeutic laparotomy. This article is protected by copyright. All rights reserved.

Language: en