title: Blunt Trauma in Paediatric Patients - Experience from a Small Centre.
abstract: OBJECTIVE
  Despite great prevention efforts, blunt abdominal trauma still remains a leading cause of injury, especially in the paediatric population. Abdominal trauma is the main culprit of serious children's injury and the most common area of initially missed diagnosis with a fatal outcome.
  
  
  OBJECTIVE
  The purpose of this study was to determine the incidence, aetiology, grades of abdominal organ injuries, diagnosis, management and outcome of blunt abdominal trauma in a paediatric population.
  
  
  METHODS
  This is a retrospective study of 31 patients with isolated parenchymatous abdominal organs, treated in a single centre. Stable patients with no signs of peritonitis and insignificant changes in laboratory findings were managed conservatively. Unstable patients received surgery.
  
  
  RESULTS
  The leading cause of injuries were traffic accidents (64.5%), followed by fall from a height (22.5%), bicycle handlebar injuries (6.45%), contact sport and child abuse (3.22% each). The majority of injured children (90.32%) were managed conservatively. Only three patients (9.68%) were operated on due to complete avulsion and organ smash, or devascularization of the injured organs. Diagnostic computed tomography (CT) scan examination was performed on 93.5% of patients. Few patients had grade I and grade V injuries, while the largest proportion of patients had grade III and IV injuries. The most frequently injured organs were the spleen and kidney. There was no mortality.
  
  
  CONCLUSIONS
  The results emphasize that conservative treatment was appropriate for all stable patients with blunt abdominal trauma regardless of organ injury grade. The success of non-operative management depends upon proper patient selection. The choice of non-operative treatment should be based predominantly on physiological response, rather than grade injury on CT scan.
authors.affiliation: Clinic for Paediatric Surgery, Nis, Serbia.|Knjaza Miloša Street 63, 18220 Aleksinac, Serbia. ivonadj74@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Djordjevic
authors.affiliation: Clinic for Paediatric Surgery, Nis, Serbia.
authors.forename: A
authors.initials: A
authors.lastname: Slavkovic
authors.affiliation: Clinic for Paediatric Surgery, Nis, Serbia.
authors.forename: Z
authors.initials: Z
authors.lastname: Marjanovic
authors.affiliation: Clinic for Paediatric Surgery, Nis, Serbia.
authors.forename: D
authors.initials: D
authors.lastname: Zivanovic