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Liver injuries in children: The role of selective non-operative management (Abstract)

Faouzi Nouira, Kerkeni Yosra, Ben Amor Anissa, Ben Ahmed Yosra, Charieg Aouatef, Khemakhem Rachid, Ghorbel Soufi-ane, Jlidi Said, Ben Kahlifa Sonia, Chaouachi Beji

Unity of Pediatric Surgery, Children’s Hospital, Tunis, Tunisia

 

Abstract

Aims: Liver injuries occur commonly in blunt abdominal trauma. This study set out to describe the causes and the role of selective non-operative management of liver injuries in children.

Materials and methods: A retrospective review of 51 patients with a discharge diagnosis of traumatic liver injuries at Tunis Children’s Hospital, over a 14-year period from 1996 to 2009.

Results: We identified 51 patients with liver trauma. The median age was 7 years. Boys accounted for 58% (n= 30), and the most common cause was traffic accident. Head injuries were the most common associated injuries. Forty nine patients (96%) required non-operative management without complications. The mean in-hospital stay was 10 days in this group. The ultrasound demonstrated complete resolution and healing after 3-6 months. Two patients underwent surgery. The mortality rate was 0,2 %.  

Conclusion: Safe, non-operative management involves careful serial examination, a CT scanning facility and close monitoring of the patient in a fully equipped high-dependency unit with trained staff to run it. Even though most patients can be treated non-operatively the challenge is to identify the severely injured child early and institute aggressive resuscitation and expedite laparotomy.

 

Key words: children, liver trauma, blunt liver injury

 

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