Результаты хирургического лечения закрытой травмы печени и селезёнки у детей

Хабибулла Акилов; Шарофиддин Соатмуродов; Фарход Примов

doi:10.47689/2181-3663-vol4-iss2-pp19-33

Khabibulla Akilov Doctor of Medical Sciences, Professor, Head of the Department of Surgery and Pediatric Surgery, Director of the Center for the development of professional qualification of medical workers, Tashkent, Uzbekistan
Sharofiddin Soatmurodov PhD applicant, Pediatric Surgery Department, Republican Research Center of Emergency Medicine, Deputy Director for Medical Affairs, Syrdarya Branch of the Republican Research Center of Emergency Medicine
Farkhod Primov Doctor of Medical Sciences, Associate Professor, Department of Surgery and Pediatric Surgery, Center for the development of professional qualification of medical workers, Tashkent, Uzbekistan.

DOI

https://doi.org/10.47689/2181-3663-vol4-iss2-pp19-33

Keywords

children , blunt abdominal trauma , FAST protocol , surgical treatment , comparative analysis

Abstract

Aim. To perform a comparative analysis of surgical outcomes in children with blunt abdominal trauma (BAT).

Materials and Methods. We analyzed outcomes in 365 children with hepatic and splenic injuries admitted to the Republican Research Center of Emergency Medicine (RRCEM) in 2006–2024. Two cohorts were compared: a retrospective cohort (2006–2017, n=165) – managed with standard diagnostic methods, and a prospective cohort (2017–2024, n=200) – in which the FAST protocol was incorporated into the diagnostic algorithm. Assessed variables included mechanisms of injury, time to admission, injury characteristics by AAST grade, volume of free intraperitoneal fluid, hemodynamic parameters, types of surgical intervention, postoperative mortality, and length of hospital stay. Statistical analysis employed the χ² test and Student’s t-test.

Results. Over the study period (2006–2024), annual BAT caseload increased from sporadic cases to more than 40 per year, predominantly due to road-traffic incidents (45.9%) and falls from height (26.8%). Isolated injuries predominated in both groups (73.7%). By location, splenic injuries led (35.8%), followed by hepatic injuries (32.3%). Across cohorts, AAST grades I–II accounted for 69–71.8% of liver injuries and 68–69% of splenic injuries. In the prospective cohort, conservative management was used more frequently (40.0% vs 13.3%; p<0.001) and laparotomy was performed less often (8.0% vs 15.2%; p=0.047). The conversion rate from laparoscopy to laparotomy declined from 50.0% to 9.6% (p<0.001). Mortality was 3.0% in the comparison cohort versus 1.5% in the prospective cohort (p<0.05). Mean length of stay decreased from 14.2±2.6 to 7.5±2.7 days (p<0.001).

Conclusion. Integration of FAST into the diagnostic pathway optimized the management of pediatric BAT – reducing unnecessary laparotomies, shortening hospitalization, and lowering mortality. FAST should be regarded as a mandatory component of the evaluation algorithm for pediatric parenchymal abdominal injuries.

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Published

2025-08-20

How to Cite

Akilov , K., Soatmurodov, S. and Primov, F. 2025. Results of surgical treatment for closed-injury trauma to the liver and spleen in children. Preventive Medicine and Health. 4, 2 (Aug. 2025), 19–33. DOI:https://doi.org/10.47689/2181-3663-vol4-iss2-pp19-33.