Paediatric blunt thoracoabdominal trauma: Specific considerations and diagnostic approach

Thoracoabdominal trauma is one of the leading causes of morbidity and mortality in paediatrics and requires a diagnostic and therapeutic approach distinct from that of adults. Children's greater radiosensitivity necessitates careful justification for each diagnostic test involving radiation and demands optimisation of imaging protocols with appropriately adapted parameters. Strategies such as dual-bolus computed tomography (CT), limiting the scan area, and using non-radiating imaging modalities help minimise exposure. In addition, it is essential to apply clinical prediction rules and paediatric-specific protocols, as well as to promote multidisciplinary consensus to enable an individualised approach. Treatment depends primarily on haemodynamic stability rather than imaging findings. It is crucial to recognise scenarios such as non-accidental injury and the hypoperfusion complex to avoid diagnostic errors. This article aims to serve as a guide to support the diagnostic process of blunt thoracoabdominal trauma in paediatrics, highlighting the key differences between paediatric and adult patients. It also reviews the indications for each imaging modality and emphasises the importance of optimising CT protocols.