Revista do Colegio Brasileiro de Cirurgioes · 2026
Clinical characteristics and risk factors for interventional management of abdominal trauma in pediatric patients admitted to a Pediatric Intensive Care Unit in Brazil.
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Volpon Leila Costa, Araujo Camila Maekawa DE, Souza Anderson DE Paula, Aragon Davi Casale, Scarpelini Sandro, Carlotti Ana Paula DE Carvalho Panzeri
Аннотация
INTRODUCTION: To investigate the clinical characteristics and risk factors associated with interventional treatment in critically ill pediatric patients with Intra-abdominal Trauma (IAT).
METHODS: This was a retrospective cohort study of patients younger than 18 years with IAT admitted to a Pediatric Intensive Care Unit (PICU) at a Brazilian emergency hospital between January 2015 and January 2024. Patients with hollow viscus injury were excluded. Demographic, clinical, treatment, and outcome data were collected from medical records. Patients were divided into two groups according to management strategy: interventional or conservative.
RESULTS: During the study period, 41 patients with IAT were admitted to the PICU; 35 were included in the study. Most patients were male (77.1%), with a median age of 9.6 years (range, 0.7-17 years), and more than half had Injury Severity Score (ISS) values greater than 25. Motor vehicle collisions were the most common mechanism of injury (68.6%). The most frequently injured organs were the liver (57.1%) and spleen (40%). Fifteen patients (42.9%) underwent interventional management: 11 (73.3%) surgical intervention and 4 (26.6%) interventional radiology. Hypotension on admission and the need for massive transfusion were identified as risk factors for interventional treatment. Two patients (5.7%) died; both underwent damage control laparotomy.
CONCLUSIONS: In this cohort of critically ill pediatric patients with solid organ IAT, 42.8% required interventional management. Hypotension on admission and the need for massive transfusion were risk factors for interventional management in this population.
METHODS: This was a retrospective cohort study of patients younger than 18 years with IAT admitted to a Pediatric Intensive Care Unit (PICU) at a Brazilian emergency hospital between January 2015 and January 2024. Patients with hollow viscus injury were excluded. Demographic, clinical, treatment, and outcome data were collected from medical records. Patients were divided into two groups according to management strategy: interventional or conservative.
RESULTS: During the study period, 41 patients with IAT were admitted to the PICU; 35 were included in the study. Most patients were male (77.1%), with a median age of 9.6 years (range, 0.7-17 years), and more than half had Injury Severity Score (ISS) values greater than 25. Motor vehicle collisions were the most common mechanism of injury (68.6%). The most frequently injured organs were the liver (57.1%) and spleen (40%). Fifteen patients (42.9%) underwent interventional management: 11 (73.3%) surgical intervention and 4 (26.6%) interventional radiology. Hypotension on admission and the need for massive transfusion were identified as risk factors for interventional treatment. Two patients (5.7%) died; both underwent damage control laparotomy.
CONCLUSIONS: In this cohort of critically ill pediatric patients with solid organ IAT, 42.8% required interventional management. Hypotension on admission and the need for massive transfusion were risk factors for interventional management in this population.