Interventional radiology and open surgery: An effective partnership for solid organ trauma

Area of Science:

• Pediatric Surgery
• Trauma Management
• Interventional Radiology

Background:

• Paediatric blunt abdominal solid organ injury (BASOI) management is evolving.
• Interventional radiology (IR) is increasingly incorporated, but data on its pediatric application is limited.

Purpose of the Study:

• To evaluate the application and clinical outcomes of IR in pediatric BASOI.
• To assess the effectiveness of non-operative management strategies.

Main Methods:

• Retrospective review of pediatric BASOI cases (February 2012 - October 2019).
• Injuries graded using American Association for the Surgery of Trauma (AAST) guidelines.
• Analysis of treatment pathways including non-operative, surgical, and IR interventions.

Main Results:

• 106 children with BASOI; liver (71%), spleen (29%), and renal (27%) injuries were most common.
• 89.6% managed non-operatively; 15% required secondary intervention (14 IR, 1 surgery).
• No deaths or organ loss occurred in patients requiring secondary management, irrespective of injury grade.

Conclusions:

• Conservative management is successful for the majority of pediatric BASOI.
• Interventional radiology is a safe and effective adjunct for all injury grades, complementing surgical interventions.