Blunt Abdominal Trauma in Pediatric Patients with Dr. Sanjay Arora and Dr. Mike Menchine
Pediatric patients are at higher risk for occult injuries such as duodenal hematomas and pancreatic contusions and have therefore traditionally been observed. In a prospective study of 1,295 pediatric patients with blunt abdominal trauma, 1,085 had a normal CT scan. Of these patients, 737 were admitted for observation. None of the 348 patients who were discharged returned to the emergency department. Of the patients who were admitted, only 2 had complications, neither of which required surgical intervention (1 perinephric hematoma and 1 mesenteric injury.) The authors’ of this study concluded pediatric patients with blunt abdominal trauma and a normal CT scan do not need to be admitted for observation. However, this study does not address other reasons for admission such as pain control, social issues, or polytrauma. Dr. Arora and Dr. Menchine go on to suggest admission and observation are warranted if one ore more of the following are present: abdominal or flank ecchymosis, seat belt sign, ileus, hematuria or hematochezia, vomiting, or persistent abdominal tenderness.
Acad Emerg Med. 2008;15(10):895-9