Journal of Trauma and Injury

Original Article

Pediatric hepatic pseudoaneurysm formation following blunt and penetrating abdominal trauma: a 5-year retrospective analysis: James Green, Christopher Bunting, Kuran Rati, Seth Cox, Mandeep Basra, Robert Hooper, Elika Kashef, Nicholas Alexander, Maryam Alfa-Wali, Neeral R. Patel; J Trauma Inj. 2026;39(2):137-143. Published online June 30, 2026; DOI: https://doi.org/10.20408/jti.2025.0219

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Abstract PDF: Purpose
Hepatic pseudoaneurysm (HPA) is a rare but potentially life-threatening sequela of liver trauma. This study aimed to evaluate the number of children diagnosed with HPAs following blunt and penetrating liver trauma at a major trauma center in London over a 5-year period.
Methods
A retrospective analysis was conducted of patients aged <18 years with liver injuries admitted to our institution between 2017 and 2022. Patients were identified through the local trauma registry. Data collected included patient demographics, imaging details (including ultrasound scanning and computed tomography [CT]), liver injury grade, and management plans.
Results
Thirty-four patients were identified (mean age, 12 years; range, 1–17 years). There were 26 men (76.5%) and 8 women (23.5%). Twenty-three patients (67.6%) sustained blunt injuries, and 11 (32.4%) sustained penetrating liver injuries. Among 30 patients (excluding 4 patients who died), 18 (60.0%) underwent repeat CT imaging. CT imaging identified four HPAs (13.3%), two of which were treated with embolization. Of the 12 patients who did not undergo repeat CT, 6 (50.0%) had follow-up ultrasound scanning.
Conclusions
Hepatic pseudoaneurysms following trauma are uncommon. Their management in the pediatric population presents challenges regarding follow-up imaging, particularly the use of CT. Although the absence of standardized protocols complicates surveillance strategies, an individualized approach informed by patient-specific factors is essential. Contrast-enhanced ultrasound may optimize HPA detection while minimizing radiation exposure.; Summary

Case Reports

Use of helicopter emergency medical services with a physician on board in severe pediatric trauma in Korea: a case report: Yoonsuk Lee, Gunwoo Kim, Pil Young Jung; J Trauma Inj. 2024;37(3):224-227. Published online June 14, 2024; DOI: https://doi.org/10.20408/jti.2023.0080

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Abstract PDF: In Korea, helicopter emergency medical services (HEMS) with a physician on board were introduced in September 2011, funded by both central and regional governments. HEMS was integrated into the Korean emergency medical system to address the need for EMS in remote rural areas. The present report describes 16-month-old twins who fell from the fifth floor of an apartment building, located approximately 100 km from the nearest level I trauma center. Utilizing HEMS along with initial emergency management by an emergency physician, the patients were transported to the level I trauma center within the critical “golden hour.” The children had sustained multiorgan injuries. Without intervention at the scene by an emergency physician, a fatal outcome was anticipated for both children. With the use of HEMS, one patient died, but the other survived with a good prognosis. The use of HEMS flights with an emergency physician on board may improve outcomes for pediatric patients with severe trauma in medically underserved rural areas.; Summary

Massive traumatic abdominal wall hernia in pediatric multitrauma in Australia: a case report: Sarah Douglas-Seidl, Camille Wu; J Trauma Inj. 2023;36(4):447-450. Published online November 7, 2023; DOI: https://doi.org/10.20408/jti.2023.0023; Correction in: J Trauma Inj 2024;37(4):309

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Abstract PDF

Traumatic abdominal wall hernia is a rare presentation, most commonly reported in the context of motor vehicle accidents and associated with blunt abdominal injuries and handlebar injuries in the pediatric population. A 13-year-old boy presented with multiple traumatic injuries and hemodynamic instability after a high-speed motor vehicle accident. His injuries consisted of massive traumatic abdominal wall hernia (grade 4) with bowel injury and perforation, blunt aortic injury, a Chance fracture, hemopneumothorax, and a humeral shaft fracture. Initial surgical management included partial resection of the terminal ileum, sigmoid colon, and descending colon. Laparostomy was managed with negative pressure wound therapy. The patient underwent skin-only primary closure of the abdominal wall and required multiple returns to theatre for debridement, dressing changes, and repair of other injuries. Various surgical management options for abdominal wall closure were considered. In total, he underwent 36 procedures. The multiple injuries had competing management aims, which required close collaboration between specialist clinicians to form an individualized management plan. The severity and complexity of this injury was of a scale not previously experienced by many clinicians and benefited from intrahospital and interhospital specialist collaboration. The ideal aim of primary surgical repair was not possible in this case of a giant abdominal wall defect.

Summary

Citations

Citations to this article as recorded by

Erratum to “Massive traumatic abdominal wall hernia in pediatric multitrauma in Australia: a case report”

Journal of Trauma and Injury.2024; 37(4): 309. CrossRef

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