Blunt Abdominal Injuries in Children: Demography at a Pediatric Surgery Department of a Tertiary Level Hospital in Bangladesh

Aims: Injuries are becoming major causes of morbidity and mortality throughout the world and one-third of the injured patients have abdominal injuries. The aim of the study was to analyze epidemiological characteristics of blunt abdominal injuries in children at a tertiary government facility in a lower middle-income country.

Study Design: Retrospective chart review study.

Place and Duration of Study: Department of Pediatric Surgery, Chattogram Medical College Hospital, between January 2017 and June 2020.

Methods: This was a tertiary-level hospital-based study on children admitted with blunt abdominal injuries. Epidemiology, mechanism of injury, other associated injury, organ involvement, treatment and outcome were analyzed.

Results: Among 309 patients, male to female ratio was 3.48:1. Age ranged from 32 days to 12 years (mean 7.29 ± 3.05 7 years). Majority were school-age children (183, 59.22%). The commonest mechanisms of injuries were road traffic accidents (RTA), 60.52% and fall from a height, 20.71%. Mechanism of injury did not vary between sexes(P=0.39). Solid organ injury was present in 58 patients (18.77%) and gastrointestinal perforation in 20 (6.47%). There was no association between mechanism of injury and presence of visceral injury (P=0.38) or solid organ injury (P=0.59). Other associated injuries were significantly related with presence of both abdominal visceral and solid organ injuries (P=0.19 and 0.00, respectively). Majority were treated conservatively (229, 74.11%) and laparotomy was performed in 51 (16.50%). Seven (2.27%) patients died.

Conclusion: Abdominal organs were susceptible to injuries by all types of trauma throughout the year. Solid organs were more vulnerable than hollow viscus. Presence of other associated injuries were related to presence of visceral injury.