This paper is only available as a PDF. To read, Please Download here.
From 1978 to 1988 228 children under 13 years of age with liver injury following blunt abdominal trauma were studied prospectively. Motor vehicle related accidents were responsible for 85 per cent of the injuries. Isotope liver scan established the diagnosis and identified the pattern of injury. Multiple injuries were seen in 157 patients — predominantly head injuries. The liver was the only intra-abdominal organ injured in 119 patients. There were 69 associated splenic, 33 renal, 21 pancreatic and 3 bowel injuries. There were two deaths (0.88 per cent).
Management was non-operative in 215 patients, with resolution of the liver injury in 214. Blood was transfused in 92 patients (40 per cent) (mean volume 20 ml/kg). There were 10 complications; two liver abscesses responded to antibiotics. Follow-up showed complete resolution of the liver injuries. Eight underwent laparotomy because of instability, deterioration or other extrahepatic visceral injuries. All required blood transfusion (mean volume 30 ml/kg). There were eight complications following surgery.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Injury
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Splenic trauma in the paediatric patient: The integrated roles of ultrasound and computed tomography.Pediatrics. 1986; 78: 576
- A comparison between scintigraphy and computed abdominal tomography in blunt liver and spleen injuries in children.J. Pediatr. Int. 1990; (in press)
- Complementary roles of radionuclide and computed tomographic imaging in evaluating trauma.in: Semin. Nucl. Med.13. 1983: 86
- Blunt trauma to the liver. Analysis of management and mortality in 323 consecutive patients.Ann. Surg. 1988; 207: 126
- Blunt liver trauma in children: Nonoperative management.J. Pediatr. Surg. 1985; 20: 14
- A prospective study of 91 patients undergoing both computed tomography and peritoneal lavage following blunt abdominal trauma.J. Trauma. 1986; 26: 602
- Investigation of childhood blunt abdominal trauma: A practical approach using ultrasound as the initial diagnostic modality.Pediatr. Radiol. 1987; 17: 373
- Methodologic considerations in comparing imaging methods.AJR. 1984; 144: 1117
- Blunt hepatic trauma in children: Experiences with operative and nonoperative management.J. Pediatr. Surg. 1984; 19: 519
- Gastrointestinal injuries in childhood: Analysis of 53 patients.J. Pediatr. Surg. 1989; 24: 580
- The activity of glutamic-oxalacetic and glutamic-pyruvic transaminases (GOT and GPT), ornithine, carbamoyl-transferase (OCT) and alkaline phosphatase (AP) in serum in closed liver injury: An experimental study in dogs.Acta Chir. Scand. 1966; 131: 476
- Upper abdominal trauma in children: Imaging evaluation.AJR. 1984; 142: 449
- Hollow viscus rupture due to blunt trauma.Surg. Gynecol. Obstet. 1986; 163: 552
- Blunt hepatic injury and elevated hepatic enzymes: A clinical correlation in children.J. Pediatr. Surg. 1984; 19: 457
- Blunt liver injury in childhood: Evaluation of therapy and current perspective.Surgery. 1986; 100: 542
- Liver trauma study.J. Pediatr. Surg. 1989; 24: 1035
- A prospective study comparing nuclear scintigraphy and computerized axial tomography in the initial evaluation of the trauma patient.Ann. Surg. 1983; 198: 611
Accepted: December 19, 1990
© 1991 Published by Elsevier Inc.