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Pediatric blunt abdominal trauma in the emergency department: evidence-based management techniques

Nicole Schacherer, Jill Miller, Kelli Petronis

    Pediatric Emergency Medicine Practice
    |May 2, 2015
    PubMed

    Insights

    Pediatric blunt abdominal trauma is a common, often unrecognized, cause of death. Evaluating injuries requires a targeted approach, balancing diagnostic tests with radiation exposure concerns.

    Area of Science:

    • Pediatric Trauma Surgery
    • Emergency Medicine
    • Diagnostic Imaging

    Background:

    • Blunt abdominal trauma is a leading cause of mortality in children.
    • It is frequently an unrecognized fatal injury, highlighting diagnostic challenges.
    • Current evaluation strategies involve laboratory tests, sonography, and computed tomography (CT).

    Purpose of the Study:

    • To review common injury mechanisms and patterns in pediatric blunt abdominal trauma.
    • To examine current diagnostic evaluation and management techniques.
    • To address the controversy surrounding the utility of various diagnostic studies and radiation exposure concerns.

    Main Methods:

    • Literature review of diagnostic evaluation and management strategies for pediatric blunt abdominal trauma.
    • Discussion of laboratory findings, sonography, and CT scan utility.
    • Emphasis on clinical examination and injury mechanism in guiding diagnostic workup.

    Main Results:

    • The routine use of all diagnostic studies may not be necessary.
    • Controversy exists regarding the value of specific imaging modalities.
    • Concerns about radiation-induced malignancy are driving efforts to limit CT scan use.

    Conclusions:

    • A thoughtful and directed diagnostic workup is essential.
    • History, physical examination, and mechanism of injury should guide the selection of diagnostic tests.
    • Minimizing unnecessary radiation exposure in pediatric patients is a priority.

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