RT Book, Section
A1 Stoffan, Alex
A1 Mooney, David P.
A2 Ziegler, Moritz M.
A2 Azizkhan, Richard G.
A2 Allmen, Daniel von
A2 Weber, Thomas R.
SR Print(0)
ID 1100438452
T1 Abdominal Trauma
T2 Operative Pediatric Surgery, 2e
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-162723-8
LK accesspediatrics.mhmedical.com/content.aspx?aid=1100438452
RD 2024/04/24
AB Most  solid  organ  injuries  can  and  should  be  managed  nonoperatively.Laparotomy  is  still  indicated  for  hemodynamic  instability  or  peritonitis.Diaphragmatic  injuries,  once  diagnosed,  are  often  associated  with  thoracic  and  abdominal  injuries,  and  should  be  explored  and  repaired  from  the  abdomen.Splenorrhaphy  remains  the  surgery  of  choice  for  unstable  patients  with  splenic  injury.Angioembolization  may  supplant  operation  for  hemodynamically  stable  patients  with  persistent  hemorrhage.Exploration  for  liver  injury  is  rarely  necessary,  though  some  patients  may  require  later  interventional  procedures  for  complications.Gastric  injury  is  uncommon,  though  it  may  occur  more  often  in  children  than  in  adults,  and  usually  occurs  along  the  greater  curvature.The  management  of  pancreatic  ductal  injury  remains  controversial:  nonoperative,  resection,  or  drainage.The  duodenum  is  more  exposed  and  more  prone  to  injury  in  pediatric  patients.Intestinal  injuries  are  best  diagnosed  on  physical  examination,  and  therapeutic  delay  of  less  than  24  hours  only  mildly  increases  morbidity.