ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Surgery
Volume 13 - 2025 | doi: 10.3389/fped.2025.1567744
This article is part of the Research TopicPediatric Wounds And Tissue Engineering/RegenerationView all 4 articles
Analysis and Experience Summary of 64 Cases of Pediatric Closed Liver Trauma: A Retrospective Study from Two Centers in China
Provisionally accepted
Jie Liu1*
Xiu Wenli2
Feifei Wang2Wenjie Bu3
Guangyu Wang1
Zhenjie CHU1Bao Wang1Ke Xu3Zihui Cheng3Nan Xia4Qian Dong2Aiqin Lin3- 1Department of Pediatric Surgery, First Affiliated Hospital of Wannan Medical College, Wuhu, China
- 2The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
- 3Wannan Medical College, Wuhu, Anhui Province, China
- 4Qingdao University, Qingdao, Shandong Province, China
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Background: Pediatric liver trauma is relatively common due to the liver's large size, superficial location, and fragile tissue.Objective: To investigate the clinical characteristics, diagnostic and treatment methods of pediatric closed liver trauma, and summarize treatment experiences.: A retrospective analysis was conducted on 64 pediatric patients with closed liver trauma admitted to Yijishan Hospital and Qingdao University Affiliated Hospital from May 2013 to July 2024. Diagnosis and treatment results were analyzed. Laboratory indicators (Hb, ALT, AST, m-AST, TBIL, PT, APTT) were compared before and after conservative therapy.The study included 39 males and 25 females. According to the AAST Liver Injury Grading Scale, there were 13 Grade I, 30 Grade II, 11 Grade III, 8 Grade IV, and 2 Grade V cases. 51 patients received non-surgical treatment, 11 had surgery due to hemodynamic instability, and 2 Grade V patients died from severe injury. All surviving patients were discharged after recovery with no bleeding or biliary stricture observed during follow-up. Significant differences were found in Hb, ALT, AST, m-AST, PT, and APTT before and after treatment in the non-surgical group (P<0.05), while TBIL showed no significant difference (P=0.102). In the surgical group, significant differences were found in Hb, ALT, AST, and m-AST (P<0.05), but not in PT, APTT, and TBIL (P>0.05).Logistic regression analysis indicated that Hb and m-AST at admission were independent predictors of surgical intervention.Most Grade I and II, and some Grade III pediatric patients with stable hemodynamics can be treated non-surgically. Severe liver trauma (Grade IV and above) requires surgical intervention if hemodynamic instability occurs.
Keywords: Liver, Trauma, diagnosis, Treatment, Pediatrics
Received: 28 Jan 2025; Accepted: 18 Jun 2025.
Copyright: © 2025 Liu, Wenli, Wang, Bu, Wang, CHU, Wang, Xu, Cheng, Xia, Dong and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jie Liu, Department of Pediatric Surgery, First Affiliated Hospital of Wannan Medical College, Wuhu, China
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