1. Solid Organ trauma an Offally good approach Juliette King Department Paediatric surgery Starship

2. Haggis

3. Background

4. 1/1/09-31/12/2013  146 patients identified from the prospectively managed trauma database.  10 excluded as did not have injury of Liver, Spleen, Kidney, Pancreas.  44% were direct admissions the rest transferred in

5. Demographics  Age Mean 9 (1-15)  Sex 74% Male  3 deaths from other injuries

7. Mechanism

9. Tests  Elevated transaminases  Decreased haemaglobin  Micro or macroscopic haematuria  Elevated amylase

10. Ethnicity

11. Signs and symptoms  Handlebar marks  Bruises over flanks  Unconscious patient  Abdominal tenderness  Seat belt marks  Chest or pelvic injury

12. Organ Injured

13. AAST Grading Liver http://www.aast.org/library/traumatools/injuryscoringscales.aspx

14. Grade of Injury

15. Length of stay

16. APSA guidelines

17. Conclusion  Solid organ trauma is common and can have fairly benign seeming mechanisms of injury.  If they are suspected contrast enhanced CT is the imaging of choice  They can usually be managed conservatively following grading by CT  We are still very conservative in our management.  We are looking to creating a guideline for in patient stay.

19. References  Hynick et al 2013 J Trauma Acute Care Surg Volume 76, Number 1  Stylianos Journal of Pediatric Surgery, Vol 35, No 2 (February), 2000: pp 164-169  Aguyau et al Journal of Pediatric Surgery (2010) 45, 1311–1314  Leinwand et al Journal of Pediatric Surgery, Vol 39, No 3 (March), 2004: pp 487-490  St Peter et al Journal of Pediatric Surgery (2013) 48, 2437–2441  Yang et al Journal of Pediatric Surgery (2008) 43, 2264–2267