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Traumatic injuries of the alimentary tract in children
S R Akel1, F F Haddad, H A Hashim
1Department of Surgery, American University of Beirut Medical Center, Lebanon.
Insights
Instrumental procedures can cause rare traumatic alimentary tract perforations in children. Prompt recognition and surgical management are crucial for survival in these pediatric cases.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Instrumentation Safety
Background:
- Traumatic alimentary tract perforations secondary to instrumentation are rare but serious complications in pediatric patients.
- These injuries can occur across all pediatric age groups, with a notable risk in neonates and young infants.
Purpose of the Study:
- To review cases of traumatic alimentary tract perforations secondary to instrumentation in children.
- To highlight the importance of awareness for prompt diagnosis and management.
- To discuss preventive measures for iatrogenic gastrointestinal injuries.
Main Methods:
- Retrospective review of eight pediatric patients managed for traumatic alimentary tract perforations secondary to instrumentation.
- Analysis of injury location (upper vs. lower alimentary tract) and management strategies.
- Evaluation of patient outcomes, including survival rates.
Main Results:
- Eight pediatric patients were identified over a 10-year period (1986-1995).
- Five patients sustained upper alimentary tract injuries (3 hypopharyngeal, 1 esophageal, 1 gastric).
- Three patients had lower alimentary tract injuries (1 transverse colon, 2 rectal).
- Surgical management was required for all but two patients, and all patients survived.
Conclusions:
- Traumatic alimentary tract perforations due to instrumentation are infrequent but critical pediatric emergencies.
- Prompt surgical intervention is associated with high survival rates in these cases.
- Implementing preventive strategies is essential to reduce the incidence of these iatrogenic injuries.
Abstract:
Traumatic alimentary tract (AT) perforations in children secondary to instrumentation, though rare, can occur at any age, especially in neonates and young infants. Awareness of such a possibility is essential for prompt management to be initiated. Over a 10-year period (1986-1995), eight pediatric patients with AT perforations secondary to instrumentation were managed at the American University of Beirut Medical Center. Five had upper AT injuries that included three hypopharyngeal, one esophageal, and one gastric lesion. The remaining three patients had lower AT injuries involving the transverse colon in one and the rectum in two. All the patients but two (one with a hypopharyngeal and one with an esophageal injury) were managed surgically and all survived. These rare injuries are discussed in addition to the preventive measures to be taken.