[Children with blunt trauma to the liver].

Abstract

In 3 children, 2 boys aged 13 years and an 8-year-old girl, blunt trauma to the liver was diagnosed after a fall. The first patient underwent drainage of abdominal fluid collection on multiple occasions and a stent was introduced in the biliary duct to ensure normal bile flow; the second patient was treated by arterial catheter embolisation of a segmental branch of the right hepatic artery; in the third patient, acute laparotomy was performed in view ofhaemodynamic instability and a large hepatic rupture was treated by packing. All patients recovered successfully. In the paediatric population, blunt trauma to the liver requires a multidisciplinary approach. For haemodynamically stable children, a conservative course can be taken. Arterial embolisation is the treatment of choice if there is a persistent need for volume resuscitation or blood transfusion. In case of massive haemorrhagic shock, the child should undergo laparotomy, and if the bleeding cannot be stopped, the liver should be packed according to damage-control principles.

• Authors: J B F Hulscher, J Labohm, J C Goslings, K P van Lienden, D C Aronson
• Journal: Nederlands tijdschrift voor geneeskunde (Ned Tijdschr Geneeskd) Vol. 149 Issue 49 Pg. 2705-11 (Dec 03 2005) ISSN: 0028-2162 [Print] Netherlands
• Vernacular Title: Kinderen met stomp traumatisch leverletsel.
• PMID: 16375012 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Accidental Falls
• Adolescent
• Child
• Drainage
• Embolization, Therapeutic
• Female
• Hemodynamics (physiology)
• Humans
• Laparotomy
• Liver (injuries)
• Male
• Rupture (surgery)
• Stents
• Treatment Outcome
• Wounds, Nonpenetrating (diagnosis, surgery, therapy)