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Acta Paediatr ; 102(10): 977-81, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23815746

RESUMEN

AIM: Paediatric gastrointestinal injuries (GIIs) are rare, and the aim of this multicentre study was to evaluate their outcomes in a large cohort. METHODS: Hospital databases of 10 European paediatric surgical centres were reviewed for paediatric traumatic GIIs managed between 2000-2010. RESULTS: Ninety-seven patients with a median age of 9 years (0-17 years) were identified, with 72 blunt and 25 penetrating GIIs. Initial diagnostics in 90 patients led to correct diagnosis in 71%. Diagnostics were delayed in 26 patients (median 24 h). Eighty-two patients required surgery (67 laparotomy, 12 laparoscopy and three other approaches). There was a 50% conversion in the laparoscopic group. Median hospital stay was 10 days (range 1-137 days), with longer duration influenced by associated injuries (n = 41). Diagnosis <24 h was associated with significantly shorter hospital stay compared to more than 24 h (p = 0.011). In one-third of patients, morbidities were not related to a diagnostic delay or type of injury. There were five lethal outcomes, four due to associated injuries. CONCLUSION: Initial diagnostics in traumatic paediatric GIIs provide false negatives in one-third of patients. Diagnostic delay <24 h is associated with a significantly shorter hospital stay. Although laparoscopy is associated with a conversion rate of 50%, it can be used for diagnosis in suspected cases to avoid nontherapeutic laparotomy.


Asunto(s)
Tracto Gastrointestinal/lesiones , Heridas no Penetrantes/diagnóstico , Heridas no Penetrantes/terapia , Heridas Penetrantes/diagnóstico , Heridas Penetrantes/terapia , Adolescente , Niño , Preescolar , Conversión a Cirugía Abierta/estadística & datos numéricos , Diagnóstico Tardío/estadística & datos numéricos , Europa (Continente)/epidemiología , Reacciones Falso Negativas , Femenino , Tracto Gastrointestinal/cirugía , Humanos , Lactante , Recién Nacido , Laparoscopía/estadística & datos numéricos , Laparotomía/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Masculino , Estudios Retrospectivos , Resultado del Tratamiento , Heridas no Penetrantes/etiología , Heridas no Penetrantes/mortalidad , Heridas Penetrantes/etiología , Heridas Penetrantes/mortalidad
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