Abdominal Injury by Falls from a Height in Children

ABSTRACT

OBJECTIVE: Falls from a height are the leading cause of injury and death among urban children. In this study, objective was to describe the incidence, clinical characteristics, and treatment results of the children who fell from a certain height and admitted over abdominal injury. METHODS: The medical records of patients under 15 years old admitted over abdominal injury by a fall from one meter or more height between January 1997 and December 2003 at Ewha Womans University Mokdong Hospital were analyzed retrospectively. RESULTS: Of 585 consecutive patients who admitted to our hospital after a fall from a height of 1 to 31.2 meters, 28 patients (4.8%) suffered from blunt abdominal trauma. The male to female ratio was 2.1: 1. The children between 12 months and 13 years old were the patients with 5.5 years old of the median age, and the median height fallen was 3 meters. Fifteen patients (53.6%) were during the summer and seventy-nine percent of the falls occurred between noon and 9 pm. Eighteen (64.3%) of falls occurred in residential place and 19 (67.8%) of patients arrived at the emergency department in 30 minutes after the accidents. Only 16 patients (57.1%) complained of abdominal pain. Liver injuries were found in 12 (42.9%), spleen injuries in 5 (17.9%), kidney injuries 3 (10.7%), pancreatic injuries in 1 (3.6%) and nonspecific abdominal injuries in 9 (32.1%) of cases. The increased SGOT and SGPT were found in each 23 (82.2%) and 18 (64.3%) of cases. Eleven patients (39.3%) had been associated with head injuries and limb injuries in each 17.9% and thoracic injuries in 7.1%. Twenty-five patients (89.3%) were recovered under the conservative treatments and the median length of hospital stay was 6 days (range, 2 -20 days). CONCLUSIONS: Despite the absence of abdominal symptoms or shock, falls from a height in children may carry a significant intra-abdominal organ injuries. Moreover the height of free fall cannot reliably predict the degree of the abdominal injury. Accordingly after a fall from height, the abdomen should be evaluated by CT scan for potential injury.