HEPATIC-TRAUMA IN CHILDREN - LONG-TERM FOLLOW-UP

The purpose of this report is to assess the role of long-term clinical and hepatic ultrasound (US) follow-up in children who sustained blunt liver trauma. Forty-three children with blunt hepatic injury were pro spectively studied between 1976 and 1994 in our institution. Four pati ents died (9%). Fourteen children (52%) were operated upon and 13 (48% ) were treated conservatively. Twenty-seven patients were recalled for a long-term echography (US) with a mean time span of 6 years after tr auma. The physical examination and the liver tests were normal in all patients. The US aspect of the Liver was abnormal in 22% of our cases, showing hypoechogenic areas and anomalies of the biliary tract in fou r patients (11%). Cholelithiasis secondary to hemobilia was demonstrat ed in 2 patients. Cholecystectomy was performed in one patient because of posttraumatic strictures of the biliary tract. All patients with U S anomalies of the liver and biliary tract were clinically asymptomati c and had normal liver tests. We recommend a follow-up US in children having sustained blunt hepatic injury about 6 months after the trauma. If no cholelithiasis or alteration of the biliary tract is present, n o other follow-up procedure seems necessary.