Pediatric blunt abdominal trauma: role of computed tomography vascular blush

Nonoperative management of blunt abdominal trauma is widely accepted in pediatric patients. There are few factors prospectively available to predict reliably which children will not respond to nonoperative treatment. Computed tomography scans demonstrating a vascular contrast blush are associated with arterial bleeding and the failure of nonoperative management of splenic injuries in adults. The authors describe five hemondynamically stable pediatric patients who have intraabdominal injury and a characteristic vascular contrast blush who acutely did not respond to nonoperative treatment. Vascular blush may be an indication for early laparotomy in pediatric trauma patients.