Delayed Manifestations of Abdominal Blunt Trauma in Pediatrics

Blunt abdominal trauma can injure any abdominal organs which had significant morbidity and mortality in pediatric age group. Although acute manifestations such as intraperitoneal bleeding are more common and demand critical management, delayed manifestations are less common and more likely to be missed. These delayed presentations even could be life-threatening if wouldn t have been diagnosed or treated thoroughly. The aim of this article was to review delayed manifestations of abdominal blunt trauma in pediatrics.Blunt mesenteric and bowel injury is uncommon. Acceleration – deceleration injuries, resulting in tears of the mesentery do not lead to early clinical expressions but Clinical symptoms will become apparent only once fibrosis and stricture have developed. Besides a high-index of suspicion is required when previous history of blunt abdominal trauma is associated with nonspecific abdominal complaints. Eventhe presentation of gastrointestinal perforation after blunt abdominal trauma in children can be subtle and at times delayed. Traumatic diaphragm rupture (TDR) is a rare complication of trauma in pediatric age and may be easily missed by the severity of associated injuries so that delayed emergent presentation can occur with increased rate of morbidity and mortality. Most frequently reported presenting symptoms of TDR are respiratory and abdominal. Splenic pseudoaneurysms (SPA) are a rare but serious sequel of blunt traumatic injury to the spleen. Management of adult blunt splenic trauma is well-studied, however, in children; the management is much less well-defined. Similarly posttraumatic hepatic artery pseudoaneurysms are although rare but life - threatening complication of blunt abdominaltrauma with liver damage. Pseudoaneurysms of other organs such as short gastric and renal artery have been reported. Isolated pancreatic injury occurs in less than 5% of cases of abdominal trauma events, that may be missed or the diagnosis may be delayed because the initial symptoms and signs of pancreatic injury are subtle. In isolated injuries of gallbladder, onset of symptoms may not develop acutely and Patients may not seek treatment until several days to weeks after the injury.