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  • 作者: Becker Alexander Yaslowitz Ori Dubose Joseph Peleg Kobi Daskal Yaakov Givon Adi Group Israel Trauma Kessel Boris
  • 学科: 医药卫生 >
  • 创建时间:2020-08-10
  • 出处:《中华创伤杂志(英文版)》 2020年第03期
  • 机构:Department of Surgery, Emek Medical Center, Afula, Israel; The Rappaport School of Medicine, Technion, Haifa, Israel,Department of Surgery A, Meir Medical Center, Kfar-Saba, Israel,R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, MD, USA,National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel; Emergency and Disaster Management Department, Faculty of Medicine, School of Public Health, Tel-Aviv University, Israel,Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel,National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel,Emergency and Disaster Management Department, Faculty of Medicine, School of Public Health, Tel-Aviv University, Israel,The Rappaport School of Medicine, Technion, Haifa, Israel; Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel
  • 简介:AbstractPurpose:Pelvic fracture evaluation with abdominopelvic computed tomography (CT) and formal CT cystography for rule out of urine bladder injury have been commonly employed in pediatric trauma patients. The additional delayed imaging required to obtain optimal CT cystography is, however, associated with increased doses of ionizing radiation to pelvic organs and represent a significant risk in the pediatric population for future carcinogenic risk. We hypothesized that avoidance of routine CT cystography among pediatric pelvic fracture victims would not result in an appreciable rate of missed bladder injuries and would aid in mitigating the radiation exposure risk associated with these additional images.Methods:A retrospective cohort study involving blunt trauma pelvic fractures among pediatric trauma patients (age<14) between the years 1997 and 2016 was conducted utilizing the Israeli National Trauma Registry. Statistical analysis was performed using SAS statistical software version 9.4 via the tests of Chisquare test and two-sided Fisher's exact test. A p value of less than 0.05 was considered statistically significant.Results:A total of 1072 children were identified from the registry for inclusion. Mean age of patients was 7.7 years (range 0-14) and 713 (66.5%) were male. Overall mortality in this population was 4.1% (44/1072). Only 2.1% (23) of pediatric patients with pelvic fractures had bladder injury identified, with just 9 children having intraperitoneal bladder rupture (0.8% of all the patients).Conclusion:The vast majority of blunt pediatric trauma victims with pelvic fractures do not have urine bladder injuries. Based on our study results we do not recommend the routine utilization of CT cystography in this unique population.

  • 标签: Tomography X-ray computed Cystography Bladder injury Child Pelvic fracture