Evaluation of Management and Outcome of Blunt Liver Trauma in Pediatrics and Adults

Abstract

Abstract Background The options for the management of blunt hepatic trauma in adults and children are nonoperative management, adjuncts of conservative management such as angioembolization, and open surgery. Objective To describe and compare the management strategies and outcomes of blunt liver trauma in pediatrics and adults over a specified period of time in Ain Shams University hospitals. Patients and Methods A retrospective analytical comparative study conducted at Ain Shams University Hospitals during the period from August 2022 to September 2023. 53 cases of admitted blunt liver injuries were included: 34 in the pediatric age group and 19 in the adult group. Results Outcome of conservative management was very promising regarding resolution and fewer rate of complications in both groups. However, Adjuncts of conservative management (angioembolization and image- guided drainage) were crucial in some patients managed conservatively and needed more often in the adult group. Conclusion Our study highlights significant differences in the management and outcomes of blunt liver trauma between pediatric and adult patients. Despite similarities in the mode of trauma, pediatric patients generally experienced less severe liver injuries and had higher success rates with conservative management compared to adults. Operative interventions and blood transfusion requirements were more common in adults, reflecting the higher incidence of high- grade injuries and active bleeding in this group. While the incidence of complications did not differ significantly, clinical outcomes were better in pediatric patients, with all experiencing complete resolution. These findings underscore the importance of tailored treatment approaches based on age and injury severity to optimize outcomes in blunt liver trauma.