[Management of abdominal trauma in children]

Area of Science:

• Pediatric Surgery
• Diagnostic Imaging
• Radiology

Background:

• Pediatric abdominal trauma management has evolved significantly over 15 years.
• Advances in imaging and a more conservative approach have driven these changes.
• Non-surgical management is increasingly preferred, supported by clinical surveillance and imaging.

Purpose of the Study:

• To review the advantages and disadvantages of different imaging techniques for pediatric abdominal trauma.
• To discuss the adaptation of imaging workup to a conservative management strategy.
• To highlight the importance of considering radiation exposure in pediatric patients.

Main Methods:

• Literature review on imaging modalities for pediatric abdominal trauma.
• Analysis of clinical experience favoring ultrasound (US) with selective computed tomography (CT) use.
• Evaluation of helical CT and Doppler US in patient assessment.

Main Results:

• Non-surgical management is common, requiring comprehensive imaging evaluation.
• Helical CT and Doppler US offer benefits but require careful consideration.
• Euratom Directive 97-43 emphasizes reduced radiation exposure for children, promoting alternative imaging.

Conclusions:

• Imaging protocols for pediatric abdominal trauma should be individualized.
• Preference is given to US with selective CT use, balancing diagnostic accuracy and radiation safety.
• Protocol decisions depend on imaging availability, expertise, and clinical context.