Related Experiment Videos
[Intramural duodenal hematoma after blunt abdominal injury in childhood. Case report]
F Fasolini1, P Lichtenhahn, P Aeberhard
1Chirurgische Klinik, Kantonsspital Aarau.
Insights
Blunt abdominal trauma in children rarely causes gastrointestinal injuries, with the duodenum being the most common site. Most duodenal injuries are hematomas, often resolving without surgery, but lacerations require intervention.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Gastrointestinal Radiology
Background:
- Blunt abdominal trauma in children is uncommon.
- Gastrointestinal injuries are rare sequelae of blunt abdominal trauma.
- The duodenum is the most frequently injured site among pediatric gastrointestinal trauma cases.
Observation:
- Duodenal injuries constitute 30% of gastrointestinal trauma in children.
- Associated injuries, both intra-abdominal and extra-abdominal, are present in 60% of cases.
- The most common duodenal injury is a parietal hematoma, with lacerations being less frequent.
Findings:
- Approximately 50% of duodenal hematomas resolve non-operatively.
- Surgical intervention is indicated for persistent obstruction after 10-14 days or if a duodenal laceration with peritonitis/retroperitonitis develops.
- Computed tomography (CT) is the preferred diagnostic imaging modality.
Implications:
- Early diagnosis and appropriate management are crucial for favorable outcomes in pediatric duodenal trauma.
- Non-operative management is effective for a significant proportion of duodenal hematomas.
- CT scans play a vital role in diagnosing and guiding treatment for these injuries.
Abstract:
Gastrointestinal injuries after blunt abdominal trauma in childhood are seldom. In 30% of the patients, the site of injury is the duodenum. In 60% associated injuries including other abdominal or extraabdominal lesions are found. Most frequently duodenal damage consists in parietal haematoma, seldom in duodenal laceration. Duodenal haematoma can be resolved non-operatively in 50%. Operation is recommended for children in whom there is no evidence of partial resolution of the obstruction after 10-14 days or in cases with development of a parietal laceration with peritonitis and/or retroperitonitis. For diagnostic computed tomography is the examination of choice.