Global Journal of Medical Research, F: Diseases, Volume 22 Issue 1

Problems of Early Diagnosis of the Abdominal Cavity with Concomitant Abdominal Trauma in Children Khadjibaev A.M. α , Juraev J.A. σ , Pulat K. Sultanov ρ & Makhmudjon M. Pulatov Ѡ Abstract- In the structure of child mortality, trauma comes first among the causes of death in children over one year of age. Mortality in children with multiple and concomitant trauma remains high - from 7.1 to 22%. The aim of the work is to improve the results of diagnostics and surgical treatment of post-traumatic stress disorder with closed abdominal trauma using medical tactics in dependence on the severity of trauma and the degree of damage to the organs and the use of modern methods of surgery. Materials and methods: Over the past 10 years (2010-2019), 118 patients aged 1 to 18 years with associated injuries were hospitalized in the Republican Scientific Center for Emergency Medical Aid (RSCEMA) in the department of emergency surgery. All patients underwent a comprehensive examination, which included X-ray studies, CT, endovisual and endosurgical interventions. Results: The most frequent combinations of abdominal injuries were observed in patients with head trauma – 104 (88%) cases, chest – 31 (29.8%), limbs – 16 (13.6%), spine – 2 (1.7%) and pelvis – 1 (0.84%). Injuries were received by victims of road accidents – 78 (66.4%) cases, falls from a height – 39 (33.0%) and domestic injuries – 1 (0.84%). Among the patients, a combination of 6 anatomical areas was identified in 6 (5%) cases; 5 regions – 8 (6.8%); 4 regions – 18 (15.2%); 3 regions – 46 (39%) and 2 regions – 40 (33.9%) Conclusions: Improvement of minimally invasive methods for diagnosing abdominal injuries by expanding the therapeutic capabilities of video laparoscopy improves the results of surgical treatment for concomitant abdominal trauma. Keywords: polytrauma, concomitant trauma, catatrauma, complex diagnostics, abdominal trauma. Author α : Doctor of Medical Sciences, Professor, Minister of Health of the Republic of Uzbekistan. Author σ : Doctoral student, Resident Doctor, Republican Scientific Center of Emergency Medical Care, Tashkent, Uzbekistan. Author ρ : Doctor of Medical Sciences, Doctor of Emergency Surgery at the RSCEMA, Tashkent, Uzbekistan. e-mail: sultanovpk@bk.ru I. I ntroduction feature of modern childhood traumatism is an increase in the number of many types of injuries – combined and multiple trauma, leading to an increase in mortality and disability [1]. In peacetime, concomitant injury most often occurs because of road accidents and falls from a height [7]. According to the many authors, the mortality rate in childhood with associated injuries ranges from 7.1% to 22% [2,3]. High mortality is associated with late diagnosis of internal bleeding, as well as the emergence of several foci of nociceptive pathological impulses, which, with a sufficiently long and intense exposure, leads to disintegration and disruption of urgent compensatory mechanisms, therefore, to an increase in the severity and resistance of traumatic shock. [3.4] The combination of trauma to the abdominal organs with damage to other anatomical areas of the body aggravates the condition of the victim, significantly complicates the diagnosis and worsens the prognosis [6]. In a timely manner undetected abdominal injuries lead to an error in the choice of surgical tactics. Despite the improvement of laboratory instrumental and minimally invasive diagnostic methods, in the surgery of abdominal injuries, the errors of diagnosis and, accordingly, the surgical treatment tactics are 20-38%. [3.4] The aim of the study is to develop a therapeutic and diagnostic algorithm for surgical treatment for concomitant abdominal trauma in children. II. M aterials and M ethods Over the past 10 years (2010-2019), 118 patients aged 1 to 18 years with combined injuries were hospitalized in the Republican Scientific Center for Emergency Medical Aid (RSCEMA) in the department of emergency surgery. Of these, 61 (33.9%) patients applied through the emergency room, 51 (43.2%) – by gravity without a referral, and 6 (5%) – by gravity in a referral from other institutions. 83 (70.3%) were boys and 36 (29.6%) were girls. Taking into account the periodization of childhood adopted in pediatrics, the material is divided into three age groups: younger, from 0 to 3 years – 17 (14.4%) children, average age 1.8 ± 1.1 years; average, A 13 Year 2022 Global Journal of Medical Research Volume XXII Issue I Version I ( D ) F © 2022 Global Journals Author Ѡ : Ph.D, Resident of the Department of Emergency Surgery No. 1 of the Republican Scientific Center for Emergency Medical Aid of the Republic of Uzbekistan.