title: Liver injuries in children: the role of selective non-operative management.
abstract: BACKGROUND
  Trauma remains the leading cause of mortality in the pediatric population. Liver injuries occur commonly in blunt abdominal trauma.
  
  
  OBJECTIVE
  To assess the selective non-operative management of liver injuries in children.
  
  
  METHODS
  A retrospective review of 51 patients with a discharge diagnosis of traumatic liver injuries at Tunis Children's Hospital, over a 14-year period from 1996 to 2009.
  
  
  RESULTS
  We identified 51 patients with liver trauma. The median age was 7 years. Boys accounted for 58% (n= 30), and the most common cause was traffic accident. Head injuries were the most common associated injuries. Forty-nine patients (96%) required non-operative management without complications. The mean in-hospital stay was 10 days in this group. The ultrasound demonstrated complete resolution and healing after 3-6 months. Two patients underwent surgery for hemodynamic instability. The mortality rate was 0.2 %.
  
  
  CONCLUSIONS
  Safe, non-operative management involves careful serial examination, a CT scanning facility and close monitoring of the patient in a fully equipped high-dependency unit with trained staff to run it. Even though most patients can be treated non-operatively the challenge is to identify the severely injured child early and institute aggressive resuscitation and expedite laparotomy.
authors.affiliation: Tunis Children's Hospital, Tunisia.
authors.forename: Faouzi
authors.initials: F
authors.lastname: Nouira
authors.forename: Yosra
authors.initials: Y
authors.lastname: Kerkeni
authors.forename: Anissa
authors.initials: A
authors.lastname: Ben Amor
authors.forename: Yosra
authors.initials: Y
authors.lastname: Ben Ahmed
authors.forename: Aouatef
authors.initials: A
authors.lastname: Charieg
authors.forename: Rachid
authors.initials: R
authors.lastname: Khemakhem
authors.forename: Soufiane
authors.initials: S
authors.lastname: Ghorbel
authors.forename: Said
authors.initials: S
authors.lastname: Jlidi
authors.forename: Sonia
authors.initials: S
authors.lastname: Ben Kahlifa
authors.forename: Beji
authors.initials: B
authors.lastname: Chaouachi
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology / Q000628:therapy