Blunt abdominal trauma in children at Kenyatta National Hospital.

OBJECTIVE

To determine the pattern of intra-abdominal injuries arising from blunt abdominal trauma and evaluate the management of blunt abdominal trauma and its outcome.

DESIGN

Retrospective study.

SETTING

Paediatric Surgical Department, Kenyatta National Hospital (KNH), Nairobi.

SUBJECTS

Fifty-five children who were admitted and treated for blunt abdominal trauma in KNH between January 1983 and December 1993.

MAIN OUTCOME MEASURES

Morbidity as determined by operative management and complications, mortality and period of hospital stay.

RESULTS

Incidence of trauma was high in males with male to female ratio of 2:1. Incidence of trauma was prevalent in seven year age group. Motor vehicle accidents accounted for the majority of injuries. Most patients arrived late in hospital. Sixty per cent underwent laparotomy. Three quarters of these had positive findings. The spleen was the organ most commonly injured. Hypovolaemic shock was the most frequent complication. One patient died during management. On average, patients stayed for seven days in the ward before discharge.

CONCLUSION

Blunt abdominal trauma more commonly affected male children. Motor vehicle accidents were a major aetiologic factor in blunt abdominal trauma in children seen in Kenyatta National Hospital. Twenty-five per cent of the children were subjected to unnecessary operation. This was due to unavailability of sensitive diagnostic modalities.