Oztürk Hayrettin, Otcu Selcuk, Onen Abdurrahman, Dokucu Ali Ihsan
Department of Pediatric Surgery, Dicle University Medical School, 21280 Diyarbakir, Turkey.
Eur J Emerg Med. 2003 Sep;10(3):164-8. doi: 10.1097/00063110-200309000-00002.
To describe the retroperitoneal organ injury pattern after anterior penetrating abdominal injury in children.
The paediatric surgical department of a university teaching hospital.
All children presenting with firearm and stab wounds to the anterior abdomen between January 1983 and April 2001.
Forty-nine children (34%) with penetrating anterior abdominal wounds had retroperitoneal organ injury. The most injured organs were the descending colon in 17 patients (35%), ascending colon in eight patients (16%), and kidney in seven (14%). The most commonly associated injured organ was the small bowel. Postoperative septic complications were seen in 10 patients (20%). The most common postoperative complication was wound infection. When we compared patients with intraperitoneal organ injury with patients with retroperitoneal injury, there was no difference in parameters such as age, associated organ injury, morbidity and mortality between both groups. The main causative factor of retroperitoneal injuries was shotgun wounds, whereas it was stabbing in intra-abdominal injuries (P<0.05). The number of injured organs and the hospital stay is significantly greater in retroperitoneal organ injuries, and the trauma scores such as the Injury Severity Score (P<0.001) and the Penetrating Abdominal Trauma Index (P<0.001) were found to be significantly higher.
Retroperitoneal organ injury is commonly associated with anterior penetrating abdominal trauma. Even if there is no preoperative sign of retroperitoneal organ injury, an exploratory laparotomy and a meticulous retroperitoneal exploration should also be performed for associated retroperitoneal organ injury.
描述儿童腹部前侧穿透伤后腹膜后器官损伤模式。
一所大学教学医院的小儿外科。
1983年1月至2001年4月间所有前腹部有火器伤和刺伤的儿童。
49例（34%）腹部前侧穿透伤儿童有腹膜后器官损伤。损伤最严重的器官是降结肠，17例（35%）；升结肠，8例（16%）；肾脏，7例（14%）。最常合并损伤的器官是小肠。10例（20%）患者出现术后感染并发症。最常见的术后并发症是伤口感染。当我们比较腹膜内器官损伤患者与腹膜后损伤患者时，两组在年龄、合并器官损伤、发病率和死亡率等参数上没有差异。腹膜后损伤的主要致病因素是猎枪伤，而腹腔内损伤的主要致病因素是刺伤（P<0.05）。腹膜后器官损伤的损伤器官数量和住院时间明显更长，损伤严重程度评分（P<0.001）和穿透性腹部创伤指数（P<0.001）等创伤评分也明显更高。
腹膜后器官损伤常与腹部前侧穿透伤相关。即使术前没有腹膜后器官损伤的迹象，对于合并的腹膜后器官损伤也应进行剖腹探查和细致的腹膜后探查。
