SP7.6 - Incidence of hepatic pseudoaneurysm formation following blunt and penetrating abdominal trauma in the paediatric cohort: A 6-year retrospective analysis

Abstract Introduction Hepatic pseudoaneurysm (HPA) is a rare but potentially life-threatening sequelae of liver trauma. Little data exists in the literature in regards HPAs in paediatric patients. We aimed to determine the incidence and risk factors of HPA formation in children with blunt and penetrating liver trauma. Methods A retrospective analysis was performed on patients admitted to our institution under the age of 18, found to have liver injury on initial trauma protocoled CT imaging between 2017 & 2022. Patients were identified from The Trauma Audit and Research Network (TARN) database. Data relevant to the study aims was collected. Results 34 patients were identified. (mean age 12 ± 5.4 years 76.5% male 23.5% female) 67.6% of patients suffered blunt injury (mean ISS 34.3 +/- 20.4 95% CI [25.4-43.1] median AAST 3) and 32.4% patients suffered penetrating liver injury (mean ISS 19.5 +/- 9.61 95% CI [12.6-26.4] median AAST 3) Four patients were excluded from further analysis due to loss of life from the primary injury. 18 patients (60%) underwent repeat CT. Of the 12 patients that did not have a repeat scan, 6 patients (50%) had a repeat USS at 6 weeks. follow up CT identified 4 HPAs (11.7%), of which two were treated with embolization. Conclusion HPA formation in paediatric liver trauma presents a significant clinical challenge. While the lack of standardised protocols poses a hurdle, a personalised approach informed by individual patient factors and the use of contrast enhanced ultrasound (CEUS) may optimise HPA detection while minimising radiation exposure.