Solid Organ trauma an Offally good approach
description
Transcript of Solid Organ trauma an Offally good approach
Solid Organ trauma an Offally good approach
Juliette KingDepartment Paediatric surgery
Starship
Haggis
Background
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
Demographics Age Mean 9 (1-15) Sex 74% Male 3 deaths from other injuries
Mechanism
BoatingMotor Vehicle-insideMotor Vehicle-outsideSportFall from heightFallNAIHandlebar
Tests Elevated transaminases Decreased haemaglobin Micro or macroscopic haematuria Elevated amylase
Ethnicity
MaoriEuropeanPacific IslandIndianChineseOther
Signs and symptoms Handlebar marks Bruises over flanks Unconscious patient Abdominal tenderness Seat belt marks Chest or pelvic injury
Organ Injured
liverspleenKidneyPancreasMultiple
AAST Grading Liver
http://www.aast.org/library/traumatools/injuryscoringscales.aspx
Grade of Injury
1 2 3 4 50
5
10
15
20
25
LiverSpleenKidney
Length of stay
1 2 3 4 50
2
4
6
8
10
12
14
16
LiverSpleenKidneyAPSA
APSA guidelines
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.
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