Aunt Minnie – Medical imaging plays a key role in helping Turkish doctors diagnose victims of the Syrian civil war. They recently described their efforts to photograph children injured in blasts, and reaffirmed their findings from radiologists in other war-torn areas.
Radiologists who diagnose major injuries understand the effects of explosive injury patterns and the frequency of injuries. More than two million children have been killed in conflict areas around the world in the last 10 years, and an estimated 86% of fatal explosive injuries are caused by shockwave (barotrauma). Bombings are a threat to citizens of all ages, but children are less likely to survive than adults.
Hathay Mustafa Kemal University Hospital is located 40 kilometers from Aleppo in Syria and is one of the top hospitals in the region where the wounded were first brought from the border, which has been 11 years since the Syrian civil war broke out. Kormaz and his colleagues, including two pediatric surgeons, studied x-ray and CT imaging in 74 children with muscle and joint stiffness between 2015 and 2020.
Explosive injuries are caused by the combined effects of high pressure caused by explosive weapons and the associated secondary effects. Excessive compression force itself is sufficient to cause injury, but secondary and complex injuries may occur as a result of shrapnel fragments, impact damage after a throw, or injury after a building collapse, the authors wrote.
The age of the group was 9 years. Of the 74 patients, the findings revealed that 29 (39.2%) had a major traumatic event (PBI), 32 (43.2%) had a second blast injury (SBI), and 13 (17.6%) had complex injuries. Twenty-three (31.1%) are girls and 51 (68.9%) are boys. Radiography was performed on 32 patients (43.2%) and CT in 55 (74.3%).
Based on the study, Kormaz and colleagues developed six key recommendations that radiologists may find similarly harmful, as follows:
- An explosive injury, regardless of the type, can cause bone damage to all parts of the body in children
- Due to its disintegration feature, shrapnel can cause fractures in many different areas in the same patient, which requires careful radiological examination.
- The presence of amputations on radiographs should make radiologists suspect serious organ damage and speed up further radiological investigations.
- If there is shrapnel in the abdominal region on radiographs, the doctor should be warned of damage to the internal organ and CT should be performed if necessary.
- Radiological images of children with fractured skull should be carefully examined to determine brain damage
- The authors noted that the age in the group with the primary injury (7.13 +/- 3.8) was lower and there was a statistically significant difference compared with the group with the second major injury group (11.3 +/- 3.8), indicating that fewer children may be more prone to body composition and may be affected by stress. explosive due to the size of their small body.
Limitations of the study included that some children had an incomplete history due to the absence of their families and language problems, and some data were recorded under emergency room emergency situations and therefore may be accustomed to human error.
Finally, the most common injuries in military conflicts and civilian terrorist activities are musculoskeletal trauma, and war-related injuries in children are a major part of care in military hospitals, the authors wrote.
