Retrospective assessment of developing liver injuries in children brought to the emergency room due to the blunt abdominal trauma over the past 10 years; a single -center experience.

Abstract

OBJECTIVE: In this study it was aimed to evaluate the types of trauma, accompanying solid organ injuries, treatments, and treatment outcomes in children admitted to our clinic in the last 10 years due to blunt liver trauma.
 MATERIAL AND METHOD: The data of 47 patients who were involved in liver injuries owing to blunt abdominal trauma between July 2010-May 2020 assessed retrospectively.
 RESULTS: There were 30 (63.8%) male, 17 (36.2%) female patients who had carried out with blunt liver injuries between 1-17 (7.8±5.8) years were involved in this study. The induces of these injuries included traffic accidents 29 ( 61.7%), falls from height 12 25.5 %), bicycle accidents 4 (8.5%), objects falling on the body 1(2.1%), and 1(%2.1) after the assault. Twenty-seven (57.4%) of the patients had isolated liver injuries and 20 (42.6%) of other organ injuries.. Liver injuries were 8 patients (17.3%) stage I, 12 patients (26%) stage II, 18 patients (38.2%) stage III, 8 patients (17%) stage IV, 1 patient (2%) stage V. While all patients of stage I and II were treated conservatively, 4 patients (22.2%) who underwent surgery were stage III, 3 patients (37.5%) were stage IV and 1 patient (100%) were stage V. There was an additional ileum perforation in 2 patients in stage III and 1 patient in stage IV who underwent surgery. Thirty-nine patients (83%) were carrıed out by conservatively in these series of liver injury, whereas eight patients (17%) who had unstable vital signs underwent surgery. The mortality rate, duration of stay in intensive care and hospital, and the number of blood transfusions were higher in surgically managed patients, while hemoglobin level and blood pressure were particularly lower in surgically conducted patients.
 CONCLUSION: Conservative treatment method should be chosen in patients with a liver injury who have stable hemodynamics after blunt trauma. The shorter duration of hospital stay, less blood transfusion requirement, and lower morbidity and mortality rates are important reasons for this method to be preferred.