The nature and characteristics of abdominal injuries sustained during children's sports

Abstract

Objective: To increase the evidence base by characterizing various features of pediatric sports-related abdominal injuries.

Design: A review of the trauma database at The Children's Hospital at Westmead was undertaken for all abdominal injuries presenting to the emergency department between 2001 and 2006.

Setting: The Children's Hospital at Westmead is a tertiary-level pediatric trauma center servicing Sydney's west. It sees approximately 50,000 patients a year.

Participants: Only those injuries occurring during an organized sport were included for analysis. Thirty-three of the original 513 patients were eligible for inclusion.

Main outcome measures: The data collected included basic demographics, mechanism of injury, sport injury, time to presentation, length of stay, diagnoses, treatment, and complications. Injury severity scores were assigned retrospectively.

Results: Males sustained more injuries than females. Collisions and falls were the most common modes of injury. Rugby was the most common sport for injury. Most patients presented within 12 hours, and most presented with musculoskeletal injuries. Injury severity was usually mild; treatment, conservative; length of stay, short; and complications, uncommon. When characteristics were compared by sex, males had mostly collision injuries in high-impact/contact sports, with females having more falls in other sports. When characteristics were compared by age, the only statistically significant difference was in the organ injured: older children had more single solid organ injuries, and younger children had more multiple and hollow viscus injuries.

Conclusions: Sports-related abdominal injuries in children are mostly minor and not as common as other injury mechanisms. Despite this, they can be serious, with early diagnosis often delayed because of their subtle nature. Sports-related abdominal injuries in children require a high index of suspicion in the part of the clinician if they are to be recognized early and managed effectively.