Management of Blunt Liver Trauma in Pediatric Age Group.

Abstract Background Liver injuries take second place among all the injuries of the abdominal organs and represents 15–20%. Mortality from open liver injuries reaches 12%, while from closed injuries it amounts to 72% (Coccolini F et al. 2020). Aim to assess the outcome of management of blunt liver trauma in the pediatric age group at the department of hepato- pancreatico-biliary surgery at the national liver institute. Methods This study was conducted at National Liver Institute, Menoufiya University and included 54 pediatrics with hepatic trauma from October 2021 to October 2023. Data collected included demographics, clinical data, imaging findings, lab findings, management plane and outcome. Results Fifty-four patients were included in this study. Thirty-seven (68.52%) patients were males and 17 (31.48%) patients were females. Mean age for all patients was 10.02 ± 4.34. Twenty-six (48.15%) patients were hemodynamically stable and 28(51.85%) patients were hemodynamically unstable. The mode of trauma was compression in 7(12.96%) patients, falling from height in 8 (14.81%) patients, hit by hard object in 5(9.26%) patients and car accidents in 34(62.96%) patients. Eight (14.81%) patients had grade II liver trauma, 32(59.26%) patients had grade III liver trauma, 13(24.07%) patients had grade IV liver trauma, only one patient (1.85%) had grade VI liver trauma. Conclusion In highly experienced liver centers, even advanced grades of pediatric liver injuries still can be approached and managed non-operatively. Diligent ICU monitoring especially in the first 24 hours after trauma is critical to detect any early signs of clinical deterioration that may warrant urgent surgical intervention. In our single center experience, most of our patients were managed conservatively with excellent.