Pediatric snowboarding severe abdominal trauma: report of our experience

Purpose: The purpose of this study is to report our experience with abdominal trauma treated in high mountain with a well skilled rescue team.Materials and methods: we retrospectively review cases of severe abdominal trauma in snowboarder aged 6-18 years treated between December 2010 and December 2018. This specific high mountain ski area has a well skilled rescue team with doctor. Demographic, type of injury, type of organ trauma, morbidity and outcomes were recorded and evaluated. Results: After reviewing cases, 32 patients were enrolled, 30 were male, 18 (56%) cases had an associated head trauma with concussion and neurocognitive deficits; other 5 cases had head trauma without deficits. One patients had thoracic spine injury associated with complete spine injury. Twenty were injured in a fall, 10 collided with a stationary object and in 2 cases the mechanism of injury was unclear. 19 patients had single organ injury (18 spleen and 1 kidney); 5 patients had spleen and kidney, 6 patients liver and spleen and 2 patients had spleen, liver and pancreatic injury. Two patients underwent splenectomy and nephrectomy while only one patients had splenectomy alone. All the other were treated conservatively without morbidity. Younger patients <15 years were more likely to have multiple organ injuries (p<0.05); all patients were secured and hospitalized by helicopter support. Mean time from injury to hospitalization was under 45 minutes. Conclusion: Young male snowboarders are at risk for having multiple organ injuries; it is essential to hospitalyze these cases as soon as possible. Abdominal trauma especially after collision with stationary object are at risk for severe organ failure.