Gastrointestinal injuries in childhood: Analysis of 53 patients

Jay L. Grosfeld, Frederick Rescorla, West Karen W., Dennis W. Vane

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Gastrointestinal injuries were noted in 53 children. Blunt trauma was responsible for 51 cases, and penetrating wounds in two. There were 42 boys and 11 girls (mean age, 8.1 years). The site of injury was the stomach (2), duodenum (17), jejunum (19), and ileum (15). Types of injury included two gastric perforations, 16 duodenal hematomas, one duodenal laceration, 27 jejunoileal perforations, five mesenteric avulsions, one abdominal wall laceration and evisceration, and one entrapment necrosis between lumbar vertebrae. Diagnosis was accomplished by observing free air on x-ray, with contrast (duodenal haematoma), computed tomography, and frequent examination (noting peritoneal irritation). Thirty-four associated injuries occrred in 21 patients (40%) including the liver (6), pancreas (6), skeletal injury (6), head trauma (5), diaphragm (4), lung (3), spleen (2), and kidney (2). Nine of 16 duodenal hematomas resolved non-operatively, while seven were evacuated during other procedures. Twenty-three of 30 perforations had simple closure, while seven (jejunoileal) were resected. Mesenteric avulsions required resection in five cases-the eviscerated bowel was replaced and the entrapped bowel resected. Twently complications occurred in 13 patient, including atelectases (6), pseudocyst (5), sepsis (4), wound infection (2), subhepatic abscess (1), subglottic stenosis (1), and short bowel syndrome (1). One infant (aged 2 months) with a duodenal laceration died of head injuries (1/53=1.8% mortality). Prompt recognition and appropriate treatment result in improved survival.

Original languageEnglish
Pages (from-to)580-583
Number of pages4
JournalJournal of Pediatric Surgery
Volume24
Issue number6
DOIs
StatePublished - 1989
Externally publishedYes

Fingerprint

Lacerations
Wounds and Injuries
Hematoma
Craniocerebral Trauma
Stomach
Penetrating Wounds
Short Bowel Syndrome
Lumbar Vertebrae
Pulmonary Atelectasis
Abdominal Wall
Wound Infection
Jejunum
Diaphragm
Ileum
Duodenum
Abscess
Pancreas
Sepsis
Pathologic Constriction
Necrosis

Keywords

  • gastrointestinal
  • Trauma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Gastrointestinal injuries in childhood : Analysis of 53 patients. / Grosfeld, Jay L.; Rescorla, Frederick; Karen W., West; Vane, Dennis W.

In: Journal of Pediatric Surgery, Vol. 24, No. 6, 1989, p. 580-583.

Research output: Contribution to journalArticle

Grosfeld, Jay L. ; Rescorla, Frederick ; Karen W., West ; Vane, Dennis W. / Gastrointestinal injuries in childhood : Analysis of 53 patients. In: Journal of Pediatric Surgery. 1989 ; Vol. 24, No. 6. pp. 580-583.
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