Liver trauma in children with Syrian Civil War: How should treatment management?

Year 2022, Volume: 39 Issue: 3, 670 - 674, 30.08.2022

Mehmet Çelikkaya , Ahmet Atıcı , İnankorkmaz Korkmaz , Çiğdem El , Bulent Akçora

Abstract

Objectives: Patients with liver injuries should be considered multidisciplinary cases, and the decision to operate should be made according to each patient’s clinical and hemodynamic stability. In this study, we aimed to describe treatment management approaches and appropriate operation times for children with liver injuries resulting from the Syrian Civil War.
Methods: A total 32 patients who were admitted o a pediatric surgery clinic between 2010 and 2020 with liver injuries resulting from Syrian Civil War were examined retrospectively. Patients were evaluated according to age, gender, type of injury, accompanying trauma, treatment modality, and mortality.
Results: A total of 21 patients were injured with shrapnel, while 11 patients suffered from blast effect injury. The mean pediatric trauma score of the patients was 5.2, while the mean pediatric trauma score of the six patients who died was 3.11. Liver suturing was performed in three patients due to bleeding. A segmentectomy was performed in one patient with active bleeding in segment 7. This bleeding was stopped by binding the branches of the hepatic artery. Two patients who were operated on in Syria and to whom packing was applied due to uncontrolled bleeding were referred to Turkey. One patient with inferior vena cava injury died due to excessive blood loss and instability at the time of admission, and six patients died due to accompanying head trauma and/or multiple body trauma.
Conclusion:The main purpose in emergency operations is to stop bleeding. Rarely, however, suturing or even segment resection in the bleeding area may be required.

Keywords

Blast effect, liver, laceration, shrapnel, Syrian Civil War

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