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[Special aspects of retroperitoneal trauma in children (author's transl)]
Insights
Retroperitoneal trauma in children from birth requires careful surgical consideration, often necessitating hypoprothrombinemia management. Specific injuries like duodenal hematoma and ureteral rupture are noted in pediatric cases.
Area of Science:
- Pediatric Surgery
- Neonatal Trauma
- Abdominal Emergencies
Context:
- Birth-related retroperitoneal trauma presents unique challenges in children.
- Common injuries include parenchymal organ rupture and suprarenal gland hemorrhage.
- Specific pediatric conditions like intramural duodenal hematoma and pelvi-ureteral junction rupture occur.
Purpose:
- To outline the specific aspects of retroperitoneal trauma in childhood.
- To highlight key pediatric-specific injuries and their management considerations.
- To discuss iatrogenic complications related to neonatal respiratory support and medication administration.
Summary:
- Retroperitoneal trauma in neonates and children involves specific injuries such as suprarenal gland bleeding, duodenal hematoma, and ureteral rupture.
- Surgical intervention is guided by the child's overall condition, with hypoprothrombinemia substitution frequently required.
- Retropneumoperitoneum from positive pressure ventilation and bladder necrosis from umbilical vessel procedures are increasingly recognized.
Impact:
- Informs pediatric surgeons and neonatologists on recognizing and managing birth-related retroperitoneal injuries.
- Emphasizes the importance of clinical assessment for surgical indications in pediatric trauma.
- Raises awareness of potential iatrogenic complications in neonatal care, guiding preventative strategies.
Abstract:
During childhood, the retroperitoneal trauma resulting from birth has some specific aspects. Besides the rupture of the parenchymatous organs, in particular bleeding of the suprarenal glands occurs. The indication for surgical intervention must be based on the general condition of the child. Substitution of hypoprothrombinemia will be necesary in most cases. Intramural duodenal hematoma and rupture of the ureter in the immediate vicinity of the pelvoureteral connection, are observed especially in childhood. Retropneumooperitoneum following the increasingly popular method of intermittent respiration by above atmospheric pressure respiration of the newborn is now more frequently observed, as is necrosis of the wall of the bladder by instillation of medication and catheters in the arteries of the navel.