Non-operative Management of Blunt Liver and spleen injury in a pediatric trauma center in Shiraz, Iran

Background:The aim of this study is to evaluate the demographics, injury pattern, and blunt trauma management among children hospitalized at Namazee hospital in Shiraz, Iran, Also studying important prerequisites for a non-operative approach in children with solid organ injuries.Method:A retrospective study of blunt trauma injury in children (≤18 years) with blunt liver and spleen injuries, hospitalized in a pediatric center between April 2014 and December 2018 was performed, Splenic and liver injuries were graded, based on the American Association for the Surgery of Trauma (AAST). Data were analyzed for age, sex, operative or non-operative management, associated injury, and ICU admission.Result:During the study period 16(25%) patients with blunt liver injury, 41(64%) patients with blunt spleen injury and 7 had injuries to both organs admitted to a pediatric trauma center. Median age was 7.14 years (1-18). The most common cause of injury was motor vehicle collision, followed by fall. In all, 56 (87.5%) patients were managed conservatively and a surgical approach was required for 8 patients (12.5%).20 (31.3%) patients had additional extra-abdominal organ injuries. there was no significant difference in terms of non-surgical or surgical treatment approach between the patients with high-grade spleen or liver injury and those with low-grade spleen or liver injury (P = 0.911).Conclusion:Non-operative treatment is an acceptable treatment method in pediatric blunt trauma and operative management being applied in patients with high grade organ injury scores or abrupt changes in vital status, Close follow up is essential in patients with blunt trauma injury.