P598 Trauma of the liver in children with firearm injuries due to war: when it should be operated?

• Published in: Archives of disease in childhood Vol. 104; no. Suppl 3; p. A392
• Main Authors: Çelikkaya, Mehmet, Atıcı, Ahmet, El, Çiğdem, Akçora, Bülent
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2019
• Subjects: Bleeding; Children; Childrens health; Firearms; Hepatic artery; Injuries; Liver; Patients; Pediatrics; Surgery; Trauma; Weapons
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2019-epa.932

AimThe patients with liver injury should be considered multidisciplinary and the decision of operation should be decided according to the patient‘s clinic and hemodynamic stability. In this study, we aimed to present treatment management and appropriate operation time in children with liver injury due to war.MethodsBetween 2010–2017, patients who be followed in pediatric surgery clinic with liver injuries due to firearm were examined retrospectively. Patients; according to age, gender, type of injury, accompanying trauma, treatment modality and mortality were evaluated.Results13 patients were injured with shrapnel, 7 patients had blast effect injury. The mean pediatric trauma score of patients was 5, the mean pediatric trauma score of 6 patients who died was 3.11. Liver suturing was performed in 2 patients due to bleeding. A segmentectomy was performed in a patient with active bleeding in segment 7. Bleeding was stopped by binding the branches of the hepatic artery. 2 patients who were operated in Syria and applied packing due to unstoppable bleeding were referred to Turkey. One patient with vena cava inferior injury died due to excessive blood loss and instability at the time of admission and 6 patients died due to accompanying head trauma and/or multiple body trauma.ConclusionThe main purpose in emergency operations is stopping the bleeding. Rarely though, suturing or even segment resection in the bleeding area may require.