Blunt Abdominal Trauma in Children: A Review of 105 Cases.

Aims: The aim of the study is to identify the epidemiological, diagnostic, therapeutic, and evolutionary characteristics of patients admitted for blunt abdominal trauma (BAT) in a level 3 children's hospital. Results: The frequency was 13.1 cases/year. The mean age was 6.6 years. The sex ratio was 3.56. Road traffic accidents were the most frequent cause (54.3%). Abdominal tenderness (88.6%) was the most common physical sign. Associated lesions were found in 40% of cases. Abdominal sonography (85.7%) was the most common imaging tool followed by an abdominal computed tomography scan (34.4%). The liver was the most affected organ (24.7%) and contusion was the most frequent lesion (65.4%). The majority of patients had received nonoperative treatment (93.3%). The average length of hospitalization was 5.6 days. The outcome in all cases was favorable. No mortality was reported. Conclusions: BAT in children is common in boys under the age of 10. They are caused by road accidents. Physical examination combined with abdominal ultrasound is very important in the therapeutic decision, which in most cases is a conservative one. Morbidity and mortality are almost nil.

Acute appendicitis revealing a giant mesenteric pseudocyst: case report.

Mesenteric pseuodycst is a very rare benign childhood tumor, accounting for less than 1 out of 250,000 hospital admissions. We here report a case of giant mesenteric pseudocyst incidentally detected in a 11-year-old boy with acute appendicitis. He complained of persistent abdominal pain for the past 48 hours. He had a history of intermittent pain for several months. Physical examination showed fever and abdominal pain. Ultrasonography showed large peritoneal fluid related to peritonitis probably of appendicular origin. The patient underwent exploratory laparotomy revealing giant abdominal mesenteric cyst and acute appendicitis. Open resection of the cyst and appendectomy were performed. The diagnosis of uncomplicated acute appendicitis associated with mesenteric pseudocyst was made. Preoperative diagnosis of pseudomesenteric cysts is a clinical challenge. Knowledge is essential and suspicion should be maintained in patients with nonspecific symptoms.