BLUNT ABDOMINAL TRAUMA IN PEDIATRICSVERSUS GERIATRICS:- “ COMPARATIVE STUDY OF AETIOLOGY, MANAGEMENT, OUTCOME AND COST EFFECTIVENESS” | ||||
| The Egyptian Journal of Surgery | ||||
| Article 10, Volume 20, Issue 4, October 2001, Page 775-782 PDF (185.04 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2001.375856 | ||||
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| Authors | ||||
| Nashat N. Gwely1; Abdel Azim M.A* 1; Ahmed M. Seleem1; Mohammed M.Y. El- Gindy1; Salah I. Tantawi2 | ||||
| 1Department of Surgery, Faculty of Medicine, Mansoura University | ||||
| 2Department of Radiology, Faculty of Medicine, Mansoura University. | ||||
| Abstract | ||||
| Blunt abdominal trauma is still a big problem and a matter of argument, not only in the algorithm of diagnosis but also, in the way of management. Pediatric and geriatric patents are similar in many aspect of trauma care system, and both are similar to adults trauma data that mentioned in many previous studies. The difference are few, and not affect the overall algorithm of trauma care system. So, in management of a trauma patient never lock for the age, but for the severity and pathology of injuries. Age serves only as a guide, and background in trauma management, because of each age has its specific physiology and co-morbidity, that may be needed to be in mind. Patients and methods: -Prospective studies from May- 1998 to November 2000 include 84 victims sustained blunt abdominal trauma, and were admitted to Emergency Hospital. Victims were divided into two groups according to their ages: group 1 pediatric group : Consisted of 56 patients with age from 6 month up to 15 years group II Geriatric group: consisted of 28 patients with age above 50 years to 66 years. All patients were resuscitated, assessed clinically, and investigated laboratory and radiological. Then were taken to either non-operative or operative management. Results :The study included 84 patients divided into two groups according to their ages the geriatric group: 28 patients their ages ranged from 51- 66 years with mean age of 55+ 4-36 years, The pediatric group their age ranged from 6 month to 15 years with mean age 7.5+ 3.94 years. Motor vehicle accident was the most common cause in both groups, in pediatric group (48.2%) and geriatric group (64.4%) followed by falling from height, in pediatric group (21.4%) while (28.6%) in geriatric group. Ultrasound positive results in pediatric group were 98.2% and 100% in geriatric group while plain x-ray was useless. Most cases in both groups were managed by operative procedures 60.7% in pediatric group and 53.6% in geriatric group. The commonest pathology found at laparotomy in both groups was splenic lacerations: pediatric group 26.8%, 25% in Geriatric group, followed by liver lacerations and retroperitoneal haematoma. All mortality was due to severity of the injury and not due to post- management morbidity. On conclusion age alone does not predict outcome, so once a trauma patient reaches the resuscitation area, decisions pertaining to treatment and outcome should be based on measured severity of illness rather than age or trauma type. | ||||
| Keywords | ||||
| Blunt abdominal trauma; Pediatrics; Geriatrics; comparative study | ||||
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