CT evaluation of pediatric abdominal trauma: pitfalls and quandaries

Abstract

CT of the pediatric abdomen after blunt trauma has become a widely accepted technique for evaluation of hepatic and splenic injury. However, detection of hollow viscus and pancreatic injury remains challenging and controversial. Detection of bowel rupture (extravasated oral contrast, bowel discontinuity), pancreatic injury (laceration, separation of fragments) and bladder rupture may be difficult, particularly with inadequate technique and lack of vigilance. This article reviews findings associated with several injuries which may present diagnostic pitfalls as well as technical factors relating to the administration of enteric contrast and CT cystography.

Pitfalls in Diagnostic Radiology

“…CT is the widely accepted technique to investigate blunt abdominal trauma, even in the pediatric age group, as parenchymal injury cannot be reliably assessed with US and associated free abdominal fl uid is not always present (Hollingsworth and Bisset 2001 ). The radiologist needs to be aware that physiologic and anatomic differences between children and adults can result in different injury patterns.…”