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Hollow viscous injury in the pediatric patient
Jennifer L Bruny1, Denis D Bensard
1Department of Surgery, The University of Colorado School of Medicine, The Children's Hospital, Denver, CO 80218, USA.
Insights
Diagnosing blunt intestinal injury in children is challenging and often delayed, impacting outcomes. This review examines current approaches to diagnosing and managing these critical gastrointestinal injuries in pediatric patients.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Gastrointestinal Medicine
Background:
- Hollow visceral injuries represent 1-15% of pediatric intraabdominal injuries.
- Blunt trauma, particularly from motor vehicle accidents, is the primary cause.
- Delayed diagnosis of blunt intestinal injury is common and linked to increased morbidity and mortality.
Purpose of the Study:
- To review the current diagnostic methods for hollow visceral injuries in children.
- To examine contemporary management strategies for pediatric hollow visceral injuries.
- To highlight challenges in the timely diagnosis of blunt intestinal injury.
Main Methods:
- Literature review of diagnostic and management techniques.
- Analysis of imaging modalities for blunt intestinal injury.
- Synthesis of current clinical practice guidelines.
Main Results:
- Current imaging techniques for blunt intestinal injury are often imprecise.
- Diagnostic delays contribute to poorer outcomes in pediatric patients.
- Management strategies vary, emphasizing the need for standardized approaches.
Conclusions:
- Timely and accurate diagnosis of hollow visceral injury in children is crucial.
- Improved diagnostic tools and protocols are needed to reduce delays.
- Effective management requires a multidisciplinary approach to pediatric trauma.
Abstract:
Injuries to the gastrointestinal tract account for 1% to 15% of intraabdominal injuries in children. Most hollow visceral injuries occur following some form of blunt trauma and motor vehicle accidents remain the most common mechanism of injury. The diagnosis of blunt intestinal injury is difficult and often delayed. Current imaging modalities are imprecise and contribute to delay. Delay is associated with morbidity and mortality in both children and adults, but the length of delay remains controversial. The purpose of this review is to examine the current diagnosis and management of hollow visceral injury in children.
