Hollow viscus injuries after blunt abdominal trauma in children and adults in a comparative study

PurposeThe study aimed to compare between children and adults in the cause, the pattern of injury, who is more liable for hollow viscus injuries, and clinical presentation of patients with blunt hollow viscus.Patients and methodsThis prospective study was conducted from October 2020 to September 2021 at the Surgery Department in Minia University Hospital on patients of blunt abdominal trauma with hollow viscus injury.ResultsIn all, 53 patients had hollow viscus injures. The most common site of injury is the jejunum as there were 30 (56.6%) patients had jejunal injuries isolated or associated with other injuries. Surgical management was conducted on all patients. The most common technique used in perforated cases was primary repair and this was performed in 35 (66%) patients with gastric perforation and small jejunal injuries, resection, and anastomoses in 13 (24.5%) patients with large jejunal perforation, and Hartmann's procedure in five (9.4%) patients with sigmoid and rectal injuries. The rate of complications was in 15 (28.30%) patients in the form of surgical site infection, wound dehiscence, anastomosis leakage, paralytic ileus, chest infection, and retraction of stoma. The mortality rate was 11.3% (six patients). It was detected that the most cause of death is septic shock with multiorgan failure.ConclusionPatients with hollow viscus injury are often a cause of diagnostic uncertainty, due to potential missed injuries on initial imaging, delayed perforation due to ischemic injury, and presence of distracting injuries. The high incidence of hollow viscus injury in the younger age was due to road traffic accidents but the incidence of stomach injury was high in children due to cycle bar injury. Intestinal perforation was the most common site injury in blunt abdominal trauma. Early diagnosis and patient monitoring help early intervention and reduce the incidence of morbidity and mortality.