Download - Solid Organ trauma an Offally good approach
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Solid Organ trauma an Offally good approach
Juliette KingDepartment Paediatric surgery
Starship
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Haggis
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Background
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1/1/09-31/12/2013 146 patients identified from the prospectively
managed trauma database. 10 excluded as did not have injury of Liver,
Spleen, Kidney, Pancreas. 44% were direct admissions the rest transferred
in
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Demographics Age Mean 9 (1-15) Sex 74% Male 3 deaths from other injuries
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Mechanism
BoatingMotor Vehicle-insideMotor Vehicle-outsideSportFall from heightFallNAIHandlebar
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Tests Elevated transaminases Decreased haemaglobin Micro or macroscopic haematuria Elevated amylase
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Ethnicity
MaoriEuropeanPacific IslandIndianChineseOther
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Signs and symptoms Handlebar marks Bruises over flanks Unconscious patient Abdominal tenderness Seat belt marks Chest or pelvic injury
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Organ Injured
liverspleenKidneyPancreasMultiple
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AAST Grading Liver
http://www.aast.org/library/traumatools/injuryscoringscales.aspx
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Grade of Injury
1 2 3 4 50
5
10
15
20
25
LiverSpleenKidney
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Length of stay
1 2 3 4 50
2
4
6
8
10
12
14
16
LiverSpleenKidneyAPSA
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APSA guidelines
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Conclusion Solid organ trauma is common and can have fairly
benign seeming mechanisms of injury. If they are suspected contrast enhanced CT is the
imaging of choice They can usually be managed conservatively
following grading by CT We are still very conservative in our
management. We are looking to creating a guideline for in
patient stay.
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References Hynick et al 2013 J Trauma Acute Care Surg Volume 76, Number
1 Stylianos Journal of Pediatric Surgery, Vol 35, No 2 (February),
2000: pp 164-169 Aguyau et al Journal of Pediatric Surgery (2010) 45, 1311–1314 Leinwand et al Journal of Pediatric Surgery, Vol 39, No 3
(March), 2004: pp 487-490 St Peter et al Journal of Pediatric Surgery (2013) 48, 2437–2441 Yang et al Journal of Pediatric Surgery (2008) 43, 2264–2267