Blunt abdominal trauma in children

Abstract

Blunt abdominal trauma is the commonest cause of intra-abdominal injuries in children. The use of computerized axial tomography and non-operative management of haemoperitoneum are two significant developments in the last two decades in the management of blunt abdominal trauma in children. The concept of non-operative management was introduced in late 1979 and wherever possible remains the optimum treatment. Computerized tomography scan for paediatric abdominal trauma was first described in 1980 and remains the investigation of choice. There is no substitute, however, for a good history, astute physical examination, and strict adherence to the principles of primary and secondary survey, prompt resuscitation, vigilant monitoring and repeated evaluation.

The Utility of Clinical and Laboratory Data for Predicting Intraabdominal Injury Among Children

“…2 The use of computed tomography (CT) for the detection of IAI in children was first described in 1980. 3 Although CT scanning remains the preferred test for the diagnosis of IAI, this test is not 100% sensitive. In addition, CT is time consuming, frequently requires several valuable personnel for transport, and may require the administration of medications to sedate the child for an adequate study.…”

A Rare Case of Perforated Meckels Diverticulum Following Blunt Abdominal Trauma in a Child

“…CT scan is the investigation of choice in the hemodynamically stable patient [8] . Jamieson et al in a series of 34 CT studies in blunt abdominal trauma concluded that CT had 100% positive predictive value for bowel perforation when extra-luminal air, free fluid, wall thickening, bowel wall enhancement and bowel dilatation are present on CT [9] . In our trauma centre we do not advise CT scan if there is free air in peritoneum on X-ray findings because these patients require urgent exploration for bowel injury and intra-operatively all other organs can be visualised.…”

Sigmoid perforation and bucket-handle tear of the mesocolon after bicycle handlebar injury: a case report and review of the literature

“…Most of these episodes result in injuries to the spleen, liver, kidneys, and pancreas, which occur in about 30% of cases [6]. Gastrointestinal injuries occur in 15% of pediatric abdominal blunt-trauma cases, but perforation of a hollow viscus of the gastrointestinal tract is present in only 8.5% of these cases [7][8][9].…”