Purpose: To evaluate the effectiveness of the stepwise management of blunt abdominal trauma in children and its outcome as a life saving strategy.
Background: Management of pediatric trauma has unique challenges. The developmental stages of the patient, immature of verbal skills in younger patients, and a lack of pre-hospital information create restrictions.
Patients and methods: This is randomized prospective study that included 40 children with blunt abdominal trauma. Who were managed either by surgery or conservative (non-operative) in emergency department at Benha University Hospital after evaluation by complete history, examination and investigations. It was approved by IRB.
Results: Most children were treated by Non-operative (NOM); 25 (62.5%) but only 15 (37.5%) was treated by surgery either From 1st presentation or due to Failed non-operative. Failure of NOM was reported in 4 (16%), The intraoperative findings included Splenic injury as main presentation in 7 (46.66%). Mortality was reported in 3 (20%); two (13.33) cases were due to Shock & one case (6.66%) was due to Tension pneumothorax.
Conclusions: Investigations of pediatric trauma must be in hurry to make early plan of management. Despite conservative management can be applied in vitally stable patient and is adopted to limit complications of operative management; it may fail or has complications. So operative management is obligatory in children who are vitally unstable or failed conservative management.
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