Routine Repeat Imaging of Pediatric Blunt Solid Organ Injuries Is Not Necessary

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Whole-body PET/MRI of Pediatric Patients: The Details That Matter

Published on: December 19, 2017

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Kelsey L Fletcher1, Mitchell Meagher2, Brianna L Spencer1

  • 1Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.

The American Surgeon
|August 13, 2021
PubMed

Insights

Repeat imaging for pediatric blunt splenic and hepatic injuries is unnecessary. Delayed complications in children with these injuries are not more frequent when imaging is based on clinical changes versus routine checks.

Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Abdominal Imaging

Background:

  • Nonoperative management of blunt splenic and hepatic injuries is standard in pediatric patients.
  • Current practice shows variability in repeat imaging protocols for assessing delayed complications.
  • Evidence suggests repeat imaging should be guided by clinical status, not routine schedules.

Purpose of the Study:

  • To evaluate the rate of delayed complications and interventions in pediatric trauma patients with blunt splenic/hepatic injuries.
  • To compare outcomes between repeat imaging prompted by clinical change (CC) versus non-clinical change (NCC).

Main Methods:

  • Retrospective analysis of pediatric patients (0-17 years) with blunt splenic/hepatic injuries from 2011-2019.
  • Patients categorized based on the reason for repeat imaging: clinical change (CC) or non-clinical change (NCC).
  • Organ-specific delayed complications and interventions were analyzed by imaging group.

Main Results:

  • 307 injuries analyzed: 174 splenic, 113 hepatic, 20 both.
  • Repeat imaging occurred in 15.5% of splenic and 20.3% of hepatic injuries.
  • No significant difference in delayed complications between CC and NCC groups; only 1 of 4 interventions was identified via NCC.

Conclusions:

  • Routine repeat imaging is not necessary for pediatric blunt splenic and hepatic injuries.
  • Clinical assessment should guide the need for repeat imaging in these patients.
  • This approach can optimize resource utilization and patient management.
Abstract

Keywords:
hepatic traumapediatric traumarepeat imagingsolid organ injurysplenic trauma

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