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Liver function tests in children with blunt abdominal traumas.

O Karam1, G La Scala, C Le Coultre

  • 1Paediatric Surgery Clinic, University of Geneva Children's Hospital, Geneva, Switzerland.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|October 31, 2007
PubMed
Summary

In children with blunt abdominal trauma, low liver function tests (LFTs) do not reliably exclude significant liver injury. Clinical and radiological findings remain crucial for diagnosing liver damage.

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Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Hepatology

Background:

  • Previous research suggested specific cut-off values for liver function tests (LFTs) to rule out liver injury after blunt abdominal trauma in children.
  • The diagnostic utility of these LFT cut-offs in pediatric blunt abdominal trauma requires further validation.

Purpose of the Study:

  • To evaluate the reliability of pre-defined liver function test (LFT) cut-off values in excluding significant liver injury in pediatric patients following blunt abdominal trauma.
  • To determine if established LFT thresholds can safely rule out liver injury in this specific patient population.

Main Methods:

  • A retrospective analysis of consecutive pediatric patients admitted with blunt abdominal trauma between 2001 and 2004.
  • Comparison of liver function test (LFT) results with radiological findings (ultrasound, CT scan) and patient outcomes.
  • Statistical analysis to assess the significance of LFT variations between injured and uninjured patients.

Main Results:

  • Sixteen out of 115 patients showed radiological evidence of liver injury.
  • Patients with liver injury had significantly elevated AST and ALT levels compared to those without injury (p < 0.01).
  • A notable proportion of patients with liver injury had LFT values below previously suggested cut-off levels, including two with Grade 3 injury.

Conclusions:

  • Low admission liver function test (LFT) values cannot reliably exclude significant liver injury in pediatric blunt abdominal trauma.
  • Diagnosis of liver injury in pediatric blunt abdominal trauma depends on clinical assessment and radiological evidence.
  • Current LFT cut-off values may not be sufficiently sensitive to rule out liver injury in pediatric blunt abdominal trauma cases.