Blunt combined abdominal injuries in children

OBJECTIVE: To study treatment outcomes in children with blunt combined abdominal injuries. MATERIAL AND METHODS: Over the past 20 years, 274 children presented with combined injuries. Of these, 65 (25%) people died at the scene, 7 (0.3%) children died in hospitals. Road injuries occurred in 77% of cases. Three or more areas were injured in every third child. Sixty-three children admitted to the hospital. Standard examination included ultrasound, X-ray (including CT and MRI) and laboratory methods, laparoscopy and thoracoscopy, bladder catheterization. Three cases are described. RESULTS: Thirty-two children had spleen injury, 12 - liver injury, 7 - duodenum injury, 7 - small intestine injury, 3 - colon injury, 2 - pancreas injury. TBI was detected in 28 children, thoracic injuries - in 14, kidney injuries - in 11, fractures of pelvis and limbs - in 10 patients. Forty-four children underwent surgery. Other ones underwent conservative treatment under laparoscopic and ultrasound control. Nine 9 children required neurosurgical interventions. Four children died with severe liver injury and TBI, 2 children - with thoracoabdominal injury and TBI, one girl - with ruptured cecum, peritonitis and TBI. CONCLUSION: The objective of care for combined abdominal injuries is to save the lives of victims through diagnosis and treatment of life-threatening syndromes (shock, acute respiratory failure, bleeding, brain dislocation with vital disorders, etc.).Treatment of blunt combined abdominal injuries should consist of 2 stages. At the first stage, intraabdominal bleeding and peritonitis are eliminated, and neurosurgical correction of TBI is performed at the second stage. Children with combined injuries require timely hospitalization to multi-field hospitals.