Work

Open abdomen in pediatric catastrophic abdomen: Pre-existing pathology as a major predictor of mortality

Year: 2025

Type: article

Abstract: Background Open abdomen (OA) and subsequent temporary abdomen closure (TAC) conform to a surgical strategy used in critically ill patients, where the abdomen remains temporarily open with the viscera protected by specific techniques. Although its use is well-documented in adults, there are few studies in the pediatric population. Methods This paper retrospectively analyzes 21 pediatric cases treated with OA at the Hospital de Niños de la Santísima Trinidad Pediatric Hospital between 2019 and 2024, with the aim of evaluating the relation between pre-existing pathology and mortality. Results Most patients (81%) presented with non-traumatic pathologies, and 57.1% had mandatory indications such as hemodynamic instability or abdominal compartment syndrome. Both temporary active closure techniques (negative pressure) and temporary passive closure techniques (Bogota bag) were used. Complete closure was achieved in 71.4% of the cases with an average of 4 days. Enteroatmospheric fistula was the only prominent complication. Early parenteral nutrition was indicated in all cases. 52.4% of the patients had significant pathological histories. These patients showed a higher PELOD-2 score and a significantly higher mortality rate (72.7% vs. 10%). The PELOD-2 score proved to be a good predictor of mortality, correlating with clinical severity. The modified Björck classification, while useful for clinical description, did not show a statistically significant relation with the progress. Conclusions Mortality in pediatric patients with OA is strongly associated with the presence of pre-existing pathology. While OA is useful in the management of critically ill patients, standardized protocols and additional studies are required to optimize results and reduce mortality.

Source: Journal of Pediatric Surgery Open

DOI: 10.1016/j.yjpso.2025.100231

Authors: J. Sabarots, M.B. Dallegre, D. Rodriguez Shultz, C.A. Sferco, E. Romero Manteola, M.F. Molina

Institution: Universidad Nacional de Córdoba

Language: English

Topic: Abdominal Surgery and Complications

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,050