Clinical recognition and management of pediatric blunt abdominal trauma without ultrasound or computed tomography scan in community hospitals in Mexico
| Autor: | Giovanni Porras-Ramírez, Maía Helena Hernández-Herrera, Francisco Ramírez-Reyes, Juan Domingo Porras-Hernández |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Hospitals Community Abdominal Injuries Wounds Nonpenetrating Sensitivity and Specificity Injury Severity Score Diagnostic peritoneal lavage Laparotomy Humans Medicine Child Mexico Ultrasonography medicine.diagnostic_test business.industry Data Collection Glasgow Coma Scale General Medicine medicine.disease Surgery Survival Rate medicine.anatomical_structure Abdominal trauma Evaluation Studies as Topic Child Preschool Pediatrics Perinatology and Child Health Abdomen Female Tomography X-Ray Computed business Follow-Up Studies Abdominal surgery Pediatric trauma |
| Zdroj: | Journal of Pediatric Surgery. 34:1700-1702 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/s0022-3468(99)90648-6 |
| Popis: | Purpose : The aim of this study was to characterize the evaluation and clinical course of children with blunt abdominal trauma in second-level hospitals. Methods : The authors reviewed the medical records of children, age 1 to 17 years, admitted with blunt abdominal trauma between the years 1988 to 1998. The initial evaluation included a Pediatric Trauma Score (PTS) ABCD clinical assessment, resuscitation, diagnostic peritoneal lavage (DPL), Glasgow Coma Scale (GCS), x-ray, and laboratory values. Surgical indications included active bleeding, perforated hollow viscus, or traumatic diaphragmatic hernia. Sixty-four children with blunt abdominal trauma were divided into 4 major groups: group I, obtunded children who required abdominal surgery; group II, obtunded children that did not require abdominal surgery; group III, responsive children that required abdominal surgery; group IV, responsive children that did not require abdominal surgery. Results : Analyses of each group determined that the PTS, the GCS, and ABCD assessments accurately reflected the degree of injury and outcome. Jointly with DPL they may obviate the need of ultrasound and CT scan in hospitals of second level that do not have access to these resources. Conclusions : Recognition of blunt abdominal trauma in children may be complicated by associated multisystem injury. Systematic evaluation minimizes missed diagnosis and facilitates rapid and effective treatment. The benefit of data acquired from a good ABCD assessment, PTS, GCS, clinical and radiological, and DPL evaluation, facilitates the decision to conduct a rapid laparotomy, and they help to predict the outcome of this kind of patient. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect