INTERVENTION RADIOLOGY AND OPEN SURGERY: AN EFFECTIVE PARTNERSHIP FOR SOLID ORGAN TRAUMA
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In brief
In brief
Retrospective review of 106 pediatric blunt abdominal solid organ injuries shows 89.6% successfully managed non-operatively, with interventional radiology providing effective secondary management in 15% of cases across all injury grades. Combined IR and surgical approach achieved zero mortality and complete organ preservation.
Written by the GCMD Library team from the article.
Background
Management algorithms of pediatric blunt abdominal solid organ injury (BASOI) are evolving to include interventional radiology, but there are few studies documenting the application and clinical outcomes of cases in children.
Methods
A retrospective case note review of all paediatric BASOI at a single Paediatric Major Trauma Centre was completed. CT scans and injuries have been retrospectively graded according to AAST guidelines.
Results
In the period February 2012 - October 2019, there were 106 children (median age 10.6 years (range 10 days – 16 years)) with BASOI. Of these, 71% (n = 75) suffered liver injuries, 29% (n = 31) spleen, and 27% (n = 29) renal. 95 children (89.6%) were treated with non-operative management, of which 15% (n = 14) went on to require secondary operative management (surgery, n=1 & interventional radiology, n=14). There were no deaths or loss of organ in the group which required secondary operative management, regardless of the grade of injury.
Conclusion
The majority of BASOI can be successfully treated conservatively, but IR is a useful additional tool in their management for all grades of injury and is complementary to open surgery.