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Eur J Pediatr Surg 2020; 30(02): 215-219
DOI: 10.1055/s-0039-3400282
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Innocent Children in the Syrian Civil War

Mehmet Emin Çelikkaya 
1   Department of Pediatric Surgery, Mustafa Kemal University, Faculty of Medicine, Pediatric Surgery Clinic, Serinyol, Hatay, Turkey
,
Ahmet Atıcı
2   Department of Pediatric Surgery, Mustafa Kemal University, Hatay, Turkey
,
Çigdem EL
3   Department of Pediatrics, Mustafa Kemal University, Hatay, Turkey
,
Bülent Akçora
1   Department of Pediatric Surgery, Mustafa Kemal University, Faculty of Medicine, Pediatric Surgery Clinic, Serinyol, Hatay, Turkey
› Author Affiliations
Further Information

Publication History

16 August 2019

04 October 2019

Publication Date:
18 November 2019 (online)

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Abstract

Introduction Our aim is to present the clinical and surgical characteristics of the children affected by the Syrian civil war.

Materials and Methods Medical records were reviewed retrospectively for Syrian war victims between the ages of 0 and 18 who were brought to the emergency department of the Education and Research Hospital between March 2011 and March 2019. Each patient was evaluated with respect to demographic data (gender, age), type of injury, history of operations in Syria, injured organ(s), accompanying traumas and the mortality and trauma score.

Results The majority of our study population of 147 patients were male (108/147, 73.46%), and 39 of the total were girls (26.53%). The mean age of the patients was 9 (7.5 ± 4). The mean age of the girls was 8.5 (range: 7 months to 16 years), and the mean age of the boys was 9.2 (4 months to 17 years). Seventeen patients who had abdominal surgery in Syria were operated on again after clinical and radiological observations. A total of 83 patients were operated on in Turkey. For 66 of those patients, the operation in Turkey was their first surgery on their war injuries. Seventeen patients were operated on in Syria but needed surgery again in Turkey.

Conclusion War affects not only the battlefield, but also the neighboring countries in many aspects such as medical, social, and economic. Hollow organ injuries are the most common intraabdominal pathologies. Delayed intervention is associated with increase mortality and morbidity.

Keywords

Syrian civil war - pediatric trauma - battlefields
 

  • References

  • 1 Hinsley DE, Rosell PA, Rowlands TK, Clasper JC. Penetrating missile injuries during asymmetric warfare in the 2003 Gulf conflict. Br J Surg 2005; 92 (05) 637-642
    CrossrefPubMedGoogle Scholar
  • 2 Santa Barbara J. Impact of war on children and imperative to end war. Croat Med J 2006; 47 (06) 891-894
    PubMedGoogle Scholar
  • 3 Patton GC, Coffey C, Sawyer SM. , et al. Global patterns of mortality in young people: a systematic analysis of population health data. Lancet 2009; 374 (9693): 881-892
    CrossrefPubMedGoogle Scholar
  • 4 Ursano RJ, Shaw JA. Children of war and opportunities for peace. JAMA 2007; 298 (05) 567-568
    CrossrefPubMedGoogle Scholar
  • 5 Scope A, Farkash U, Lynn M, Abargel A, Eldad A. Mortality epidemiology in low-intensity warfare: Israel Defense Forces' experience. Injury 2001; 32 (01) 1-3
    PubMedGoogle Scholar
  • 6 Holcomb JB, McMullin NR, Pearse L. , et al. Causes of death in U.S. Special Operations Forces in the global war on terrorism: 2001-2004. Ann Surg 2007; 245 (06) 986-991
    CrossrefPubMedGoogle Scholar
  • 7 Gofrit ON, Leibovici D, Shapira SC, Shemer J, Stein M, Michaelson M. The trimodal death distribution of trauma victims: military experience from the Lebanon War. Mil Med 1997; 162 (01) 24-26
    CrossrefPubMedGoogle Scholar
  • 8 Price M, Gohdes A, Ball P. Updated Statistical Analysis of Documentation of Killings in the Syrian Arab Republic. Geneva: Human Rights Data Analysis Group; 2014
    Google Scholar
  • 9 Naaman O, Yulevich A, Sweed Y. Syria civil war pediatric casualties treated at a single medical center. J Pediatr Surg 2019 . Doi: 10.1016/j.jpedsurg.2019.02.022
    PubMedGoogle Scholar
  • 10 Tepas III JJ, Mollitt DL, Talbert JL, Bryant M. The pediatric trauma score as a predictor of injury severity in the injured child. J Pediatr Surg 1987; 22 (01) 14-18
    CrossrefPubMedGoogle Scholar
  • 11 Behbehani A, Abu-Zidan F, Hasaniya N, Merei J. War injuries during the Gulf War: experience of a teaching hospital in Kuwait. Ann R Coll Surg Engl 1994; 76 (06) 407-411
    PubMedGoogle Scholar
  • 12 Aharonson-Daniel L, Waisman Y, Dannon YL, Peleg K. Epidemiology of terror-related versus non-terror-related traumatic injury in children. Pediatrics 2003; 112 (04) e280
    CrossrefPubMedGoogle Scholar
  • 13 Klimo Jr P, Ragel BT, Jones GM, McCafferty R. Severe pediatric head injury during the Iraq and Afghanistan conflicts. Neurosurgery 2015; 77 (01) 1-7
    CrossrefPubMedGoogle Scholar
  • 14 Creamer KM, Edwards MJ, Shields CH, Thompson MW, Yu CE, Adelman W. Pediatric wartime admissions to US military combat support hospitals in Afghanistan and Iraq: learning from the first 2,000 admissions. J Trauma 2009; 67 (04) 762-768
    CrossrefPubMedGoogle Scholar
  • 15 Kirkpatrick AW, Baxter KA, Simons RK, Germann E, Lucas CE, Ledgerwood AM. Intra-abdominal complications after surgical repair of small bowel injuries: an international review. J Trauma 2003; 55 (03) 399-406
    CrossrefPubMedGoogle Scholar
  • 16 Newgard CD, Meier EN, Bulger EM. , et al; ROC Investigators. Revisiting the “Golden Hour”: an evaluation of out-of-hospital time in shock and traumatic brain injury. Ann Emerg Med 2015; 66 (01) 30-41
    CrossrefPubMedGoogle Scholar