Diagnosis and treatment for blunt hepatic trauma in children

Abstract:

Objective：To explore the most effective diagnosis and treatment methods for blunt hepatic trauma in children. Methods：Totally 32 children with blunt hepatic trauma were analyzed retrospectively in our center. Trauma causes included traffic accident in 11 cases，tumbling injury in 9 cases，blunt extrusion and blow injury in 7 cases，falling injury in 5 cases. All traumas were classified as grade Ⅰof 19 cases，gradeⅡ of 9 cases，gradeⅢ of 3 cases and grade Ⅳ of 1 case according to the grading method in American So－ciety of Trauma Surgery（AAST） in 1989. Results：Twenty-eight cases were cured after conservative treatment. Four children under－went liver laceration repair and 1 child underwent operation again due to re-bleeding. All children were well recovered. Conclusion：Most children with blunt hepatic trauma could be cured with conservative treatment under the condition of intensive care. The most important point is how to make the critical decision of operation according to ultrasound and computed tomography. Even if there is no significant hemoperitoneum，if the CT indicates severe laceration of the liver，surgical repair should actively performed.