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Characteristics of penetrating abdominal firearm injuries in children
1Department of Pediatric Surgery, Dicle University Hospital, School of Medicine, Diyarbakir, Turkey. dokucu@hotmail.com
Insights
Penetrating abdominal firearm injuries (PAFI) in children are common. The Injury Severity Score (ISS) effectively predicts injury severity, complications, and hospitalization duration in pediatric PAFI cases.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Injury Epidemiology
Background:
- Penetrating abdominal injuries, particularly from firearms, are a growing concern in pediatric populations.
- Understanding the nuances of presentation, management, and outcomes is crucial for improving care.
Purpose of the Study:
- To assess the clinical presentation, management strategies, and outcomes of children with penetrating abdominal firearm injuries (PAFI).
- To evaluate the predictive value of the Injury Severity Score (ISS) for injury severity, morbidity, and mortality in pediatric PAFI.
Main Methods:
- Retrospective review of hospital records for 69 children (age ≤15 years) treated for PAFI between 1985 and 1997.
- Analysis of injury causes (explosives, gunshot, shotgun), injured organs, postoperative complications, and Injury Severity Score (ISS) values.
Main Results:
- The most frequent injuries involved the small bowel, colon, and liver.
- A mean ISS of 16.8 was recorded; 41 children had an ISS ≥16.
- Higher ISS values correlated significantly with increased complications and longer hospitalizations. Shotgun injuries were linked to severe morbidity.
Conclusions:
- The Injury Severity Score (ISS) is a valuable tool for predicting injury severity and morbidity in children with penetrating abdominal firearm injuries.
- Effective management and outcome assessment are vital for pediatric trauma patients with PAFI.
Abstract:
Penetrating injuries of the abdomen which occur primarily from gunshots and stabbing become increasingly prevalent in children. Our purpose is to assess the presentation, management and outcome of children with penetrating abdominal firearm injuries (PAFI) and to evaluate the value of Injury Severity Score (ISS) for predicting injury severity and eventual morbidity and mortality in children with PAFI. Between 1985 and 1997, 69 children < or = 15 years of age with PAFI were hospitalized at our institution. Their hospital records were reviewed retrospectively. Of the 69 children with PAFI, 53 were boys and 16 were girls. The mean age was 9.6. The causes of PAFI were explosives (44%), gunshot (39%) and shotgun injuries (17%). The most common organ injured was the small bowel followed by colon and liver respectively. Postoperative complications were seen in 12 children. The mean value of ISS was 16.8; 41 children had an ISS value of > or = 16. The value of ISS was significantly higher in children with complication than in those without complication. The children with ISS value > or = 16 were hospitalized significantly longer than those with < or = 15 of ISS. Particularly shotgun injuries were commonly associated with severe morbidity. ISS can be useful for predicting the severity of injury and the occurrence of morbidity.