Pediatric Blunt Abdominal Trauma In The Emergency Department: Evidence-Based Management Techniques

Schacherer, Nicole MD
Miller, Jill MD
Petronis, Kelli MD
Naprawa, James MD
Zibners, Lara MD

¹Pediatric Emergency Medicine Fellow, Eastern Virginia Medical School, Children's Hospital of The King's Daughters, Norfolk, VA
²Assistant Professor of Pediatrics, Eastern Virginia Medical School, Department of Pediatric Emergency Medicine, Children's Hospital of The King's Daughters, Norfolk, VA
³Assistant Professor of Pediatrics, Eastern Virginia Medical School, Department of Pediatric Emergency Medicine, Children's Hospital of The King's Daughters, Norfolk, VA
⁴Associate Clinical Professor of Pediatrics, The Ohio State University College of Medicine; Attending Physician, Emergency Department, Nationwide Children's Hospital, Columbus, OH
⁵Honorary Consultant, Paediatric Emergency Medicine, St Mary's Hospital, Imperial College Trust; EM representative, Steering Group ATLS®-UK, Royal College of Surgeons, London, England

Prior to beginning this activity, see “Physician CME Information” on the back page.

This article is eligible for 4 trauma CME credits.

Pediatric Emergency Medicine Practice 11(10):p 1-23, October 2014.

Abstract

Blunt abdominal trauma is the third most common cause of pediatric trauma deaths, but it is the most common unrecognized fatal injury. This issue discusses common mechanisms and injuries seen in children with blunt abdominal trauma and takes a closer look at current evaluation and management techniques. The mainstays of diagnostic evaluation include laboratory, sonography, and computed tomography studies. However, the routine use of these studies may not be necessary, and controversy exists as to which studies are beneficial and which are less valuable. The concern for radiation-induced malignancy has led to increased efforts to limit radiation exposure by decreasing the use of unnecessary computed tomography scans. The history and physical examination, combined with the mechanism of injury, should be used to develop a thoughtful and directed diagnostic workup.