Čes-slov Pediat 2024, 79(1):39-45 | DOI: 10.55095/CSPediatrie2024/005

Abdominal solid organ injuries in children - identification, basic principles of clinical evaluation and managementComprehensive Report

Bořek Trávníček^{1, 2}, Markéta Nowaková^{1, 2}, Igor Dudík³, Jan Pavlíček^{1, 4}

¹ Klinika dětského lékařství, Fakultní nemocnice Ostrava a Lékařská fakulta Ostravské univerzity, Ostrava

² SIMU, Lékařská fakulta, Masarykova Univerzita v Brně

³ Klinika úrazové chirurgie a ortopedie, Fakultní nemocnice Ostrava a Lékařská fakulta Ostravské univerzity, Ostrava

⁴ Centrum biomedicínského výzkumu, Fakultní nemocnice Hradec Králové, Hradec Králové

Abdominal trauma represents a significant type of injury in childhood, the majority being of a blunt mechanism. Organs the most commonly involved are spleen, liver and kidney. If not recongnised and managed in optimal timely manner, these injuries endanger a patient with acute haemorrhagic shock or

subsequent development of infectious complications. To identify the source of bleeding and the grade of the injury, it is essential to provide an appropriate clinical as well as radiological examination, the most commonly used modalities being FAST and contrast - enhanced computer tomography (CT). In children, the majority of solid organ injuries are managed conservatively (non-operative

management, NOM). For this approach, the haemodynamic stability of a child and appropriate monitoring are crucial conditions. Regarding the invasive management, both intervention radiology and surgery are possible (based on the the services available). In isolated solid organ injury the prognosis is usually good. However, if a part of polytrauma, solid organ injuries increase the mortality in

children.

Keywords: child, surgery, solid organ injury, sonography, hemorrhagic shock, non-operative management

Accepted: December 21, 2023; Published: January 31, 2024  Show citation