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A National Analysis of Pediatric Traumatic Duodenal Injuries
Zachary C Ballinger1, Max D Hazeltine1, Alyssa Stetson1
1University of Massachusetts Chan Medical School, Worcester, Massachusetts.
The Journal of Surgical Research
|October 24, 2024
Summary
Pediatric duodenal injuries are severe, often caused by motor vehicle collisions in males. Young children with duodenal injury may indicate nonaccidental trauma (NAT), requiring increased suspicion.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Public Health
Background:
- Traumatic duodenal injuries in children are rare, severe, and complex to diagnose and manage.
- Utilizing a national database provides a comprehensive overview of pediatric duodenal injury characteristics.
Purpose of the Study:
- To analyze the demographic and clinical features of children experiencing duodenal injuries.
- To compare characteristics of duodenal injury patients with other pediatric trauma hospitalizations.
- To investigate duodenal injuries specifically related to nonaccidental trauma (NAT) in children.
Main Methods:
- Cross-sectional analysis of the 2016 Kids' Inpatient Database.
- Identification of duodenal injury cases using ICD-10-CM codes for patients under 18.
- Multivariable logistic regression to compare duodenal injury hospitalizations with other trauma cases and analyze NAT.
Main Results:
- 237 pediatric duodenal injury cases identified; patients were often older males, victims of NAT, with higher injury severity and longer hospital stays.
- Motor vehicle collisions were the most common cause; frequent concomitant injuries included lung, liver, pancreas, and bowel.
- Males (aOR 1.88), older age (aOR 1.04), and NAT (aOR 4.18) were associated with increased odds of duodenal injury hospitalization.
Conclusions:
- Pediatric duodenal injuries predominantly affect males, often from motor vehicle collisions.
- Duodenal injury in children under 3 warrants suspicion for nonaccidental trauma (NAT).
- These injuries are severe, linked to other significant trauma requiring intervention, and result in prolonged hospital stays.
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