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Published on: December 1, 2012

Perforating small bowel injuries in children: influence of time to operation on outcome

S R Thompson1, A J A Holland

  • 1Department of Academic Surgery, The Children's Hospital at Westmead, The University of Sydney, Locked Bag 4001, Westmead, NSW 2145, Australia.

Injury
|August 16, 2005
PubMed

Insights

Delay in diagnosing pediatric small bowel injury (SBI) did not significantly impact patient outcomes or hospital stays. Prompt diagnosis and treatment appear to prevent complications, even with delays up to 22.5 hours.

Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Diagnostic Imaging

Background:

  • Small bowel injury (SBI) in children requires timely surgical intervention.
  • The impact of diagnostic delay on outcomes for pediatric SBI is not well-established.

Purpose of the Study:

  • To investigate the relationship between delayed diagnosis of small bowel injury (SBI) and patient outcomes in pediatric surgical cases.
  • To determine if a diagnostic interval exceeding 8 hours affects complications or hospital stay.

Main Methods:

  • Retrospective chart review of pediatric patients with traumatic SBI requiring surgery (2000-2002).
  • Defined diagnostic interval as time from presentation to operative treatment.
  • Categorized patients into prompt (<8h) and delayed (>8h) diagnosis groups.

Main Results:

  • Thirteen pediatric patients with traumatic SBI underwent surgery; 9 were due to motor vehicle trauma.
  • Mean diagnostic interval was 9.1 hours (range 0.6-22.5 hours).
  • Six patients experienced diagnostic delays (mean 15.5 hours); no significant difference in complications or length of stay compared to prompt diagnosis.

Conclusions:

  • Diagnostic delay in pediatric small bowel injury (SBI) did not correlate with increased complications or prolonged hospital stay in this cohort.
  • Local diagnostic and treatment protocols may mitigate negative outcomes associated with delayed SBI diagnosis.
  • Further research is warranted to confirm these findings and explore specific contributing factors.

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