Blunt Solid Organ Injuries in Children

  • Rizwan Ahmad Khan


It is reported that the incidence of solid organ injuries in children with blunt abdominal trauma varies from 4% to 8% depending on the site of injury and the mode of impact. Most cases of solid organ injuries in children are minor grade, with only few injuries involving major parenchymal or vascular disruptions. The optimal management of pediatric patients with solid organ injury has shifted toward nonoperative management. But the management of high-grade injuries remains poorly defined and relies heavily on associated factors. This paradigm shift in treatment protocol of solid organ injury has many advantages. It means reducing the hospital stay and cost and less operative and postoperative complications for patients. It also means management “at home” or with the primary care pediatrician, thereby allowing intensivist and pediatric surgeon to allocate ample amount of time to more critical cases. Since children are usually healthy, with not many comorbid conditions and hardly on any medications, they are able to withstand the hemodynamic instability much better than adults [1].


  1. 1.
    Keller MS. Blunt injury to solid abdominal organs. Semin Pediatr Surg. 2004;13:106–11.CrossRefPubMedGoogle Scholar
  2. 2.
    Mattix KD, Tataria M, Holmes J, et al. Pediatric pancreatic trauma: predictors of nonoperative management failure and associated outcomes. J Pediatr Surg. 2007;42:340–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Lutz N, Mahboubi S, Nance ML, Stafford PW. The significance of contrast blush on computed tomography in children with splenic injuries. J Pediatr Surg. 2004;39:491–4.CrossRefPubMedGoogle Scholar
  4. 4.
    Partrick DA, Bensard DD, Moore EE, Karrer FM. Nonoperative management of solid organ injuries in children results in decreased blood utilization. J Pediatr Surg. 1999;34:1695–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Nance ML, Lutz N, Carr MC, et al. Blunt renal injuries in children can be managed nonoperatively: outcome in a consecutive series of patients. J Trauma. 2004;57:474–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Fulcher AS, Turner MA, Yelon JA, et al. Magnetic resonance cholangiopancreatography (MRCP) in the assessment of pancreatic duct trauma and its sequelae: preliminary findings. J Trauma. 2000;48:1001–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Tepas JJ 3rd, Frykberg ER, Schinco MA, et al. Pediatric trauma is very much a surgical disease. Ann Surg. 2003;237:775–80.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Holmes JH 4th, Tataria M, Mattix KD, et al. The failure of nonoperative management in solid organ injury: a multi-institutional pediatric trauma center experience. J Trauma. 2005;59:1309–13.CrossRefPubMedGoogle Scholar
  9. 9.
    Puapong D, Brown CV, Katz M, et al. Angiography and the pediatric trauma patient: a 10-year review. J Pediatr Surg. 2006;41:1859–63.CrossRefPubMedGoogle Scholar
  10. 10.
    De Jong WJJ, Nellensteijn DR, ten Duis HJ, Albers MJIJ, El Moumni M, Hulscher JBF. Blunt splenic trauma in children: are we too careful? Eur J Pediatr Surg. 2011;21(4):234–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Feliciano PD, Mullins RJ, Trunkey DD, Crass RA, Beck JR, Helfand M. A decision analysis of traumatic splenic injuries. J Trauma. 1992;33:340–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Davis DH, Localio AR, Stafford PW, et al. Trends in operative management of pediatric splenic injury in a regional trauma system. Pediatrics. 2005;115:89–94.CrossRefPubMedGoogle Scholar
  13. 13.
    Landau A, van As AB, Numanoglu A, Millar AJW, Rode H. Liver injuries in children: the role of selective non-operative management. Injury. 2006;37:66–71.CrossRefPubMedGoogle Scholar
  14. 14.
    van der Vlies CH, Saltzherr TP, Wilde JC, van Delden OM, de Haan RJ, Goslings JC. The failure rate of nonoperative management in children with splenic or liver injury with contrast blush on computed tomography: a systematic review. J Pediatr Surg. 2010;45(5):1044–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Giss SR, Dobrilovic N, Brown RL, Garcia VF. Complications of nonoperative management of pediatric blunt hepatic injury: diagnosis, management, and outcomes. J Trauma. 2006;61(2):334–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Rizwan Ahmad Khan
    • 1
  1. 1.Department of Pediatric SurgeryJawaharlal Nehru Medical College, AMUAligarhIndia

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