| Peer-Reviewed

Abdominal Trauma in Children: 10-Year Experience in a Teaching Hospital in Enugu, Nigeria

Received: 16 November 2019     Accepted: 2 December 2019     Published: 7 December 2019
Views:       Downloads:
Abstract

Background: Abdominal traumas are injuries to the abdomen resulting from transfer of energy from the exterior to the abdomen. It is associated with significant morbidity and mortality especially in developing countries. Methodology: Children who presented with abdominal trauma at Enugu State University Teaching Hospital between January 2007 and December 2016 were evaluated. Diagnosis of abdominal trauma was made based on clinical assessment and imaging investigation. Results: Over the ten year period, there were 42 cases of abdominal trauma with male to female ratio of 3.7:1 and mean age of 9.1 years (4-14). Fall from height, accounting for 42.9% of the cases, was the most common cause of abdominal trauma. This is followed by road traffic accident (35.7%), bicycle handle injury 14.3%, gunshot injury 7.1%. Abdominal ultrasound was the most common imaging modality. The spleen was the most injured organ, followed by liver, kidney, and intestine in descending order. Non-operative treatment was successful in 85.3% of the patients while 14.7% had surgery. The mean duration of hospital stay was 9.8 days (1-14) and the mortality was 7.1%. Conclusion: Abdominal trauma affects children of all age groups. In the current study, fall from height was the most common mechanism of injury and the spleen was the most injured organ. Non–operative treatment was the predominant modality of treatment.

Published in International Journal of Clinical Dermatology (Volume 2, Issue 2)
DOI 10.11648/j.ijcd.20190202.11
Page(s) 10-14
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Trauma, Injury, Abdominal, Spleen, Children, Experience

References
[1] Susan Guralnick. Blunt Abdominal Trauma. Pediatrics in Review. 2008; 29 (8): 294-95. doi: 10.1542/pir.29-8-294.
[2] Lynch T, Kilgar J, Al Shibli A. Pediatric Abdominal Trauma. Curr Pediatr Rev. 2018; 14 (1): 59-63. doi: 10.2174/1573396313666170815100547.
[3] Minaya-Bravo A, Aguado-Lopez H. The Challenge of Blunt Abdominal Trauma in Children: Report of a case and Review of Management. J Med Cases. 2017; 8 (11): 340-346. doi: 10.14740/jmc2901w.
[4] Rothrock SG, Green SM, Morgan R. Abdominal trauma in infants and children: prompt identification and early management of serious and life threatening conditions. Part 1: injury patterns and initial assessment. Pediatr Emerg Case. 2000; 16 (2): 106-115.
[5] Overly FL, Wills H, Valente JH. ‘Not just little adult’- a pediatric trauma primer. R I Med J. 2014; 97 (1): 27-30.
[6] Eradi B, Fisher RM. Abdominal and thoracic trauma in children. Surgery. 2010; 28 (1): 22-26.
[7] Coccolini F, Montori G, Catena F et al. Splenic trauma: WSES classification and guidelines for adult and pediatric patients. World J Emerg Surg. 2017; 12: 40. doi: 10.1186/s13017-017-0151-4.
[8] Osifo OD, Enemudo RE, Ovueni ME. Splenic injuries in children: The challenges of non-operative management in a developing country. J Indian Assoc Pediatr Surg. 2007; 12: 209-13.
[9] Schonfeld D, Lee LK. Blunt abdominal trauma in children. Curr Opin Pediatr. 2012; 24 (3): 314-8. doi: 10.1097/MOP.0b013e328352de97.
[10] Peden M, Oyegbite K, Ozanne-Smith J, editors. World Health Organization. World Report on Child Injury Prevention. Geneva: 2008.
[11] Wegner S, Colletti JE, Van Wie D. Pediatric blunt abdominal trauma. Pediatr Clin North Am. 2006; 53 (2): 243-56. doi: 10.1016/j.pci: 2006.02.002.
[12] Ayse B, Seda O. Evaluation of intra-abdominal solid organ injuries in children. Acta Biomed. 2018; 89 (4): 505-512. doi: 10.23750/abm.v89i4.5983.
[13] Yang K, Yanan L, Wang C, Xiang B, Chan S, Ji Y. Clinical features and outcomes of blunt splenic injury in children. A retrospective study in a single institution in China. Medicine (Baltimore). 2017; 96 (51): e9419. doi: 10.1097/MD.0000000000009419.
[14] Costa G, Tierno SM, Tomassini F, Venturini L, Frezza B, Cancrini G, Stella F. The epidemiology and clinical evaluation of abdominal trauma. An analysis of a multidisciplinary trauma registry. Ann Ital Chir. 2010; 81 (2): 95-102.
[15] Ameh EA, Chirdan LB, Nmadu PT. Blunt abdominal trauma in children: epidemiology, management, and management problems in a developing country. Pediatr Surg Int. 2000; 16 (7): 505-9. doi: 10.1007/s003830000406.
[16] Wabada S, Abubakar AM, Chinda JY, Adamu S, Bwala KJ. Penetrating abdominal injuries in children: a study of 33 cases. Annals of pediatric surgery. 2018; 14: 8-12. doi: 10.1097/01.XPS.0000516205.41923.be
[17] Ndour O, Camara S, Tendart V, Fall AL. Gassama F, Mbaye PA, Ndoye NA, Diouf C, Fall M, Ngom G. Blunt abdominal trauma in child: Epidemiology, diagnostic, and therapeutic analysis of 55 cases. Afr J Trauma. 2017; 6: 11-8.
[18] Streck CJ, Jewett BM, Wahiquist AH, Gutierrez PS, Russel WS. Evaluation for intra-abdominal injury in children following blunt torso trauma. Can we reduce unnecessary abdominal CT by utilizing a clinical prediction model? J Trauma Acute Care Surg. 2012; 73 (2): 371-376. doi: 10.1097/TA.0b013e31825840ab.
[19] Pariset JM, Feldman KW, Paris C. The pace of signs and symptoms of blunt abdominal trauma in children. Clin Pediatr (Phila). 2010; 49 (1): 24-8. doi: 10.1177/0009922809342464.
[20] Djordjevic I, Slavkovic A, Marjanovic Z, Zivanovic D. Blunt Trauma in Paediatric Patients. Experience from a Small Centre. West Indian Med J. 2015; 64 (2): 126-130. doi: 10.7727/wimj.2014.069.
[21] Chirdan LB, Uba AT, Chirdan OO, Gastrointestinal injuries following blunt abdominal trauma in chidren. Niger J Clin Pract. 2008; 11 (3): 250-3
[22] Ameh EA, Shelbwala PM. Challenges of managing paediatric abdominal trauma in a Nigerian setting. Niger J Clin Pract. 2009; 12 (2): 192-195.
[23] Ameh EA, Nmadu PT. Gastrointestinal injuries from blunt abdominal trauma in children. East Afr Med J. 2004; 81 (4): 194-7. doi: 10.4314/eamj.v81j4.9154.
[24] Adams SE, Holland A, Brown J. Management of Paediatric splenic injury in the New South Wales trauma system. Injury. 2017; 48: 106-13.
[25] Bairdain S, Litman AJ, Troy M. et al. Twenty years of splenic preservation at a level 1 pediatric trauma center. J Pediatr Surg. 2015; 50: 864-8.
[26] Kristoffersen KW, Mooney DP. Long term outcome of non-operative pediatric splenic injury management. J Pediatr Surg. 2007; 42: 1038-41.
[27] Hsiar M, Sathya C, de Mectral C. Population based analysis of blunt splenic injury management in Children: Operative rate in an informative quality of care indicator. Injury. 2014; 45: 859-63.
[28] Lynn KN, Werder GM, Callaghan RM. Pediatric blunt splenic trauma: a comprehensive review. Pediatr Radiol. 2009; 39: 904-16.
[29] Kundal VK, Debnath PR, Meena AK, Shah S, Kumar P, Sahu SS, Sen A. Pediatric thoracoabdominal trauma. Experience from a tertiary care centre. J Indian Assoc Pediatr Surg. 2019; 24: 264-70. doi: 10.4103/jiaps.JIAPS_152_18.
[30] Retziaff T, Hirsch W, Till H, Rolle U. Is sonography reliable for the diagnosis of pediatric blunt abdominal trauma? J Pediatr Surg. 2010; 45 (5): 912-5. doi: 10.1016/j.jpedsurg. 2010.02.020.
Cite This Article
  • APA Style

    Chukwubuike Kevin Emeka. (2019). Abdominal Trauma in Children: 10-Year Experience in a Teaching Hospital in Enugu, Nigeria. International Journal of Clinical Dermatology, 2(2), 10-14. https://doi.org/10.11648/j.ijcd.20190202.11

    Copy | Download

    ACS Style

    Chukwubuike Kevin Emeka. Abdominal Trauma in Children: 10-Year Experience in a Teaching Hospital in Enugu, Nigeria. Int. J. Clin. Dermatol. 2019, 2(2), 10-14. doi: 10.11648/j.ijcd.20190202.11

    Copy | Download

    AMA Style

    Chukwubuike Kevin Emeka. Abdominal Trauma in Children: 10-Year Experience in a Teaching Hospital in Enugu, Nigeria. Int J Clin Dermatol. 2019;2(2):10-14. doi: 10.11648/j.ijcd.20190202.11

    Copy | Download

  • @article{10.11648/j.ijcd.20190202.11,
      author = {Chukwubuike Kevin Emeka},
      title = {Abdominal Trauma in Children: 10-Year Experience in a Teaching Hospital in Enugu, Nigeria},
      journal = {International Journal of Clinical Dermatology},
      volume = {2},
      number = {2},
      pages = {10-14},
      doi = {10.11648/j.ijcd.20190202.11},
      url = {https://doi.org/10.11648/j.ijcd.20190202.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcd.20190202.11},
      abstract = {Background: Abdominal traumas are injuries to the abdomen resulting from transfer of energy from the exterior to the abdomen. It is associated with significant morbidity and mortality especially in developing countries. Methodology: Children who presented with abdominal trauma at Enugu State University Teaching Hospital between January 2007 and December 2016 were evaluated. Diagnosis of abdominal trauma was made based on clinical assessment and imaging investigation. Results: Over the ten year period, there were 42 cases of abdominal trauma with male to female ratio of 3.7:1 and mean age of 9.1 years (4-14). Fall from height, accounting for 42.9% of the cases, was the most common cause of abdominal trauma. This is followed by road traffic accident (35.7%), bicycle handle injury 14.3%, gunshot injury 7.1%. Abdominal ultrasound was the most common imaging modality. The spleen was the most injured organ, followed by liver, kidney, and intestine in descending order. Non-operative treatment was successful in 85.3% of the patients while 14.7% had surgery. The mean duration of hospital stay was 9.8 days (1-14) and the mortality was 7.1%. Conclusion: Abdominal trauma affects children of all age groups. In the current study, fall from height was the most common mechanism of injury and the spleen was the most injured organ. Non–operative treatment was the predominant modality of treatment.},
     year = {2019}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Abdominal Trauma in Children: 10-Year Experience in a Teaching Hospital in Enugu, Nigeria
    AU  - Chukwubuike Kevin Emeka
    Y1  - 2019/12/07
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijcd.20190202.11
    DO  - 10.11648/j.ijcd.20190202.11
    T2  - International Journal of Clinical Dermatology
    JF  - International Journal of Clinical Dermatology
    JO  - International Journal of Clinical Dermatology
    SP  - 10
    EP  - 14
    PB  - Science Publishing Group
    SN  - 2995-1305
    UR  - https://doi.org/10.11648/j.ijcd.20190202.11
    AB  - Background: Abdominal traumas are injuries to the abdomen resulting from transfer of energy from the exterior to the abdomen. It is associated with significant morbidity and mortality especially in developing countries. Methodology: Children who presented with abdominal trauma at Enugu State University Teaching Hospital between January 2007 and December 2016 were evaluated. Diagnosis of abdominal trauma was made based on clinical assessment and imaging investigation. Results: Over the ten year period, there were 42 cases of abdominal trauma with male to female ratio of 3.7:1 and mean age of 9.1 years (4-14). Fall from height, accounting for 42.9% of the cases, was the most common cause of abdominal trauma. This is followed by road traffic accident (35.7%), bicycle handle injury 14.3%, gunshot injury 7.1%. Abdominal ultrasound was the most common imaging modality. The spleen was the most injured organ, followed by liver, kidney, and intestine in descending order. Non-operative treatment was successful in 85.3% of the patients while 14.7% had surgery. The mean duration of hospital stay was 9.8 days (1-14) and the mortality was 7.1%. Conclusion: Abdominal trauma affects children of all age groups. In the current study, fall from height was the most common mechanism of injury and the spleen was the most injured organ. Non–operative treatment was the predominant modality of treatment.
    VL  - 2
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Department of Surgery, Enugu State University Teaching Hospital, Enugu, Nigeria

  • Sections