Biliary Complications after Hepatic Trauma in Children
Riccardo Guanà1, Carbonaro Giulia1, Andrea Brunati1
1Division of Pediatric Surgery, Regina Margherita Children's Hospital, Turin, Italy.
Journal of Emergencies, Trauma, and Shock
|November 4, 2017
Summary
Conservative treatment is effective for pediatric liver trauma in hemodynamically stable children. Biliary complications are rare but may necessitate surgery in select cases.
Area of Science:
- Pediatric Surgery
- Trauma Management
- Hepatobiliary Surgery
Background:
- Conservative treatment is the standard of care for hemodynamically stable pediatric liver trauma.
- This study evaluates outcomes and complications in pediatric patients with liver trauma.
Observation:
- A retrospective analysis of 116 pediatric patients with closed abdominal trauma was performed.
- 16 patients (13%) sustained hepatic trauma (Grade II or higher) according to the Moore liver trauma injury score.
- Only one patient required surgery due to hemodynamic instability; others received conservative management.
Findings:
- All patients, except one, were successfully managed conservatively following established guidelines.
- Biliary complications occurred in 3 patients (2.5%), with two requiring surgical drainage and one managed non-operatively.
- The overall complication rate was low, supporting conservative management.
Implications:
- Conservative management is highly effective for pediatric liver trauma, minimizing surgical intervention.
- Careful monitoring is essential to identify and manage rare biliary complications, which may require surgical intervention in specific instances.
- These findings reinforce current pediatric surgical guidelines for liver trauma.
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