Muhammad Siddique¹, Tabinda Yasmeen², Saleha Zafar², Farasat Majid¹, Tahmina Qamar³ and Attiq-u-Rehman¹

ABSTRACT

Objective: To find out pattern of pediatric abdominal and thoracic trauma, types of organ injury and treatment approaches done at a tertiary care hospital of South Punjab, Pakistan.

Study Design: A descriptive observational study

Place and Duration of Study: This study was conducted at the Department of Pediatric Surgery, Bahawal Victoria Hospital, Quaid-e-Azam Medical College, Bahawalpur, from January 2017 to December 2019.

Materials and Methods: A total of 112 patients aged less than 15 years, having history of abdominal and/or chest trauma were enrolled. Demographic data along with mechanism, site, mode and nature of injury was gathered. Biochemical markers for acute abdominal trauma, serum alanine amino transferase (ALT), serum creatinine kinase (CK) and serum lipase were obtained. Definitive treatment in terms of conservative or surgical treatment was noted.

All cases were handled using standard “Advance Trauma Life Support (ATLS)” protocols.

Results: Among of a total of 112 patients, mean age was noted to be 6.8+2.9 years. There were 68 (60.7%) boys and 44 (39.3%) girls. Road-traffic accidents were the commonest mode of trauma noted in 51 (45.5%) children, followed by fall 40 (35.7%), thermal injuries in 14 (12.5%) and assaults in 7 (6.3%). Abdomen was involved most frequently as seen in 54 (48.2%) children, thoracic trauma in 23 (20.5%) while combined thoraco-abdominal injuries were noted in 35 (31.2%). Among 82 (73%) patients, a very high serum ALT ≥ 100IU/L was found, similarly,

41(36%) patients were having raised serum CK (≥575U/L), and 26 (23%) were found with raised serum lipase (≥ 61U/L). There were 65 (58.0%) patients who were managed adopting conservative approach, minor interventions needing local anesthesia were done in 31 (27.7%), while major interventions were needed in remaining 16 (14.3%) cases. Mortality was reported in 3 cases.

Conclusion: Majority of the cases having thoraco-abdominal trauma were boys. Road-traffic accidents were the commonest mode of trauma followed by fall injuries and thermalinjuries. Abdomen was the most frequently involved anatomical site followed by combined thoraco-abdominal injuries. The most frequently raised biomarkers observed in acute abdominal injury were serum ALT, CK, and Lipase. Most of the patients were managed adopting conservative approach.

Key Words: Thoraco-abdominal trauma, road-traffic accidents, biochemical parameters conservative approach.

Citation of article: Siddique M, Yasmeen T, Zafar S, Majid F, Qamar T, Attiq-u-Rehman. Pattern of Pediatric Abdominal and Thoracic Trauma, Types of Organ Injury, biochemical parameters and Treatment