Accidentes graves provocados por caballos. Alertas y pautas de prevención / Serious accidents caused by horses. Warnings and prevention rules

Introducción: Las actividades ecuestres en los ámbitos doméstico, lúdico, deportivo y educativo son relativamente frecuentes y no están exentas de riesgos para los niños. Se dispone de muy pocos datos sobre los accidentes provocados por caballos, sus circunstancias y las claves para su prevención. Método: Estudio retrospectivo y descriptivo de los accidentes relacionados con caballos en pacientes pediátricos que requirieron ingreso hospitalario entre julio de 1997 y septiembre de 2008. Resultados: Se analizó a 17 pacientes con edades de entre 4 y 17 años, que tuvieron 14 caídas accidentales, 2 coces y una mordedura. Ocho pacientes perdieron el conocimiento tras el accidente. Sólo un paciente portaba casco protector. Se produjeron 3 fracturas craneales, 4 hemorragias intracraneales, un neumoencéfalo y 2 lesiones neuronales difusas. Se registraron 4 fracturas de huesos largos, una fractura mandibular, un acuñamiento vertebral y una avulsión parcial de pabellón auricular. Ocho pacientes requirieron cuidados intensivos, 2 pacientes necesitaron intervenciones neuroquirúrgicas y 4 pacientes precisaron reducción quirúrgica de sus fracturas. Conclusiones: El manejo de caballos por parte de niños y adolescentes puede resultar una actividad de alto riesgo. En esta serie, el traumatismo craneoencefálico fue la lesión más habitual y grave. Dada la baja adherencia a los métodos de protección observada en estos pacientes, parece necesario promover medidas que aumenten la seguridad durante las prácticas ecuestres (AU)

Introduction: Children’s equestrian activities in the domestic, play activities, sports and educational areas are relatively frequent, and are not exempt from risks. Nevertheless, there is a lack of data on horse-related injuries, their circumstances and the key points for their prevention. Method: Retrospective and descriptive study of pediatric equestrian injuries admitted to Hospital between July 1997 and September 2008. Results: A total of 17 patients with ages between 4 and 17 years were analyzed. There were 14 accidental falls, 2 kicks and 1 bite, and 8 patients had lost consciousness after the accident. Only 1 patient used a protective helmet. There were 3 skull fractures, 4 intracranial haemorrhages, 1 pneumoencephalus and 2 diffuse axonal injuries. There were also 4 long bone fractures, 1 jaw fracture, 1 vertebral wedging and 1 partial ear avulsion were recorded. A total of 8 patients required intensive care, 2 underwent neurosurgery due to an intracranial haematoma and 4 surgical fracture reduction. Conclusions: Horse handling by children and teenagers can be a high risk activity. In our cases brain trauma was the most common and severe injury. Due to the poor use of protection devices by our patients, we believe it is now necessary to take measures to increase safety in equestrian activities (AU)

[Serious accidents caused by horses. Warnings and prevention rules]. / Accidentes graves provocados por caballos. Alertas y pautas de prevención.

INTRODUCTION: Children's equestrian activities in the domestic, play activities, sports and educational areas are relatively frequent, and are not exempt from risks. Nevertheless, there is a lack of data on horse-related injuries, their circumstances and the key points for their prevention. METHOD: Retrospective and descriptive study of pediatric equestrian injuries admitted to Hospital between July 1997 and September 2008. RESULTS: A total of 17 patients with ages between 4 and 17 years were analyzed. There were 14 accidental falls, 2 kicks and 1 bite, and 8 patients had lost consciousness after the accident. Only 1 patient used a protective helmet. There were 3 skull fractures, 4 intracranial haemorrhages, 1 pneumoencephalus and 2 diffuse axonal injuries. There were also 4 long bone fractures, 1 jaw fracture, 1 vertebral wedging and 1 partial ear avulsion were recorded. A total of 8 patients required intensive care, 2 underwent neurosurgery due to an intracranial haematoma and 4 surgical fracture reduction. CONCLUSIONS: Horse handling by children and teenagers can be a high risk activity. In our cases brain trauma was the most common and severe injury. Due to the poor use of protection devices by our patients, we believe it is now necessary to take measures to increase safety in equestrian activities.

Seudoquiste pancreático en dos pacientes menores de 24 meses / Pancreatic pseudocysts in two patients under 24 months of age

El seudoquiste pancreático se produce como consecuencia de un proceso inflamatorio y/o traumático; su contenido es estéril y rico en enzimas pancreáticas. Habitualmente, debe sospecharse ante una elevación persistente de la amilasa, puesto que suele ser asintomático, salvo complicaciones. El 40-50% de los seudoquistes se resuelven espontáneamente, y deben drenarse los mayores de 6 cm y/o que persistan más de seis semanas, dado el riesgo de complicaciones. Presentamos los casos de dos pacientes menores de 24 meses con seudoquistes pancreáticos secundarios a pancreatitis agudas: el primero con una evolución típica y el segundo con una elevación aislada de la lipasa

Pancreatic pseudocysts are produced as a result of an inflammatory process or trauma, and contain a sterile, amylase-rich fluid. They should be suspected in the case of persistently increased amylase levels, as they are asymptomatic unless complications develop. Pseudocysts resolve spontaneously in 40%- 50% of cases. Those measuring more than 6 cm and/or persisting for more than 6 weeks are at high risk for the development of further complications and therefore require drainage. We describe two cases of pancreatic pseudocysts secondary to acute pancreatitis in two patients under 24 months of age. The first one exhibited the typical course, whereas, in the second one, an isolated increase in lipase was detected