HOLLOW VISCERAL INJURY AND BLUNT TRAUMA

Background: The incidence of hollow viscus injury (HVI) after blunt tr auma (BT) is variable, and differences between children and adults hav e not been well described, The purpose of this study is to determine t he age-group-related incidence and characteristics of BT-associated HV I as well as the clinical markers and consequences of delayed diagnosi s. Methods: A 9-year trauma registry review of all patients with HVI. Results: A large sample of patients (19,621) with BT were evaluated (2 ,550 less than or equal to 14 years old; 17,070 > 14 years old). One h undred thirty-nine of 17,070 (0.8%) adults had HVI compared with 27 of 2,550 (1%) children, HVI occurred more frequently in the duodenum in children (11 of 27) compared with adults (17 of 139) (p < 0.05), Among patients with abdominal wall ecchymosis, 13.5% of children had HVI co mpared with 10.6% of adults. Delays in diagnosis of HVI occurred in 9 of 27 children compared with 10 of 139 adults (p < 0.05), Delayed diag nosis was associated with increased abdominal septic complications in both children (4 of 9) and adults (2 of 10) compared with diagnosis at presentation (p < 0.05). Conclusion: HVI occurs with a similar low fr equency in both children and adults. Duodenal injuries are more common in pediatric BT patients. Abdominal wall ecchymosis is associated wit h increased HVI but is less predictive of HVI than previously describe d. Contrary to previous reports, delays in diagnosis are associated wi th increased morbidity.