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Mesenteric Injury in Blunt Abdominal Trauma in Children: Is Early Surgical Intervention Need of the Hour?
Amit Kumar Singh1, Prateek Singh Bais2, Karunesh Chand3
1Speciality of Trauma Surgery, Apex Trauma Centre, Sanjay Gandhi Post Graduate Institute of Medical Sciences, New Delhi, India.
Insights
Pediatric mesenteric injuries from blunt abdominal trauma can be managed surgically. Surgical repair, resection, and anastomosis are effective treatments for these injuries in children.
Area of Science:
- Pediatric surgery
- Trauma surgery
- Abdominal trauma
Background:
- Observational, nonsurgical management of pediatric abdominal injuries is increasing.
- Mesenteric injuries are a significant concern in blunt abdominal trauma.
- Evaluating management protocols for pediatric mesenteric injuries is crucial.
Purpose of the Study:
- To analyze the feasibility and outcomes of a management protocol for mesenteric injuries in pediatric blunt abdominal trauma.
- To assess the effectiveness of surgical interventions for pediatric mesenteric injuries.
Main Methods:
- Single-center retrospective analysis of pediatric trauma cases.
- Review of 34 cases of blunt abdominal trauma, including 13 with mesenteric injuries.
- Data collected from July 2018 to March 2020.
Main Results:
- The study included 13 pediatric patients with mesenteric injuries (male-to-female ratio 2.2:1, mean age 9.11 ± 4.90 years).
- The small bowel mesentery was the most frequently injured segment.
- Treatments involved repair of mesenteric tears, resection, and anastomosis, with or without stoma formation.
Conclusions:
- Isolated mesenteric injuries in children, regardless of grade, warrant surgical management.
- Diagnostic laparoscopy or laparotomy is recommended for all grades of isolated mesenteric injury.
- Hemodynamic status should not preclude surgical intervention for pediatric mesenteric injuries.
Objective:
There is an increasing trend of observational, nonsurgical management of abdominal injuries in children. We analyzed the feasibility and outcome of our management protocol in managing cases of the mesenteric injuries in blunt trauma abdomen in pediatric age group.
Methods:
Single-center retrospective analysis of pediatric trauma case records from July 2018 to March 2020 was performed.
Results:
Thirty-four cases of blunt abdominal trauma of whom 13 had mesenteric injuries were reviewed. The male-to-female ratio was 2.2:1, and the mean age was 9.11 ± 4.90 years. Mesentery of the small bowel was the most commonly injured segment and treatment consisted of repair of mesenteric tear, resection, and anastomosis with or without stoma formation.
Conclusions:
Isolated mesenteric injury of all grades should be managed either with diagnostic laparoscopy or laparotomy irrespective of hemodynamic status.
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