Thoracic and Abdominal Trauma: A Thirteen-Year Experience in a Tertiary Pediatric Referral Center

Background. Non-operative management (NOM) is the standard of care for haemodynamically stable paediatric thoraco-abdominal trauma; European single-centre data on complex injury patterns remain limited. Aim. To evaluate the safety and effectiveness of NOM across solid organ and hollow viscus injuries at a tertiary paediatric centre over a 13-year period. Materials and Methods. Retrospective cohort study, 80 patients (<16 years), Ca’ Foncello Hospital, Treviso, January 2013 – December 2025. Injuries graded by 2018 AAST scale; ICD-9-CM coding. Results. NOM 96.3%; failure rate 3.8%; mortality 0%; median stay 9.0 days (IQR 5.5–14.0); organ preservation 97.5%. Conclusions. Haemodynamic status determines management. Three hypotheses emerged for multicentre investigation: ureteral opacification in renal trauma; age-related splenic reserve; two-stage endoscopic approach for pancreatic ductal transection.​​​​​​​​​​​​​​​​