J Acute Care Surg.  2020 Nov;10(3):106-111. 10.17479/jacs.2020.10.3.106.

Lessons Learnt in The Management of Acute Complications following Liver Injury in Children

• Vasudeva RB
• Gadgade BD
• Lakshmi PD

• KMID: 2512848
• DOI: http://doi.org/10.17479/jacs.2020.10.3.106

Abstract

Purpose
Liver injuries constitute an important cause of hospital admissions, pediatric morbidity, and sometimes mortality. This study was undertaken to assess the spectrum of pediatric liver injuries with special emphasis on the management of acute complications.
Methods
This retrospective study used data from the Department of Pediatric Surgery, Bangalore Medical College, Bengaluru, India, between March 2013 and March 2019. All children between 1-18 years were included in the study (n = 33). Children were assessed with relevance to age, sex, mode of injury, hemodynamic stability at admission, need for blood transfusions, surgery, radiological investigations, complications, total number of days of stay in hospital, and mortality.
Results
There were 27 (81.8%) males and 6 (18.18%) were females. The most common cause for injury was a road traffic accident (60.6%). The majority (nearly 65%) of pediatric liver injuries were Grade II and III. There were 4 children who had post traumatic complications including 2 pseudoaneurysms, 1 inferior vena cava thrombus, and 1 bile leak with a biloma formation which were managed appropriately.
Conclusion
Timely and appropriate radiological evaluation is required for assessments of complications. The majority of complications can be managed conservatively, and minimally invasive techniques like endoscopic retrograde cholangiopancreatography is helpful in the management of complications.

Keyword

inferior vena cava; thrombus; accidental injury; liver; traffic accident; false aneurysm