The significance of hematuria in children after blunt abdominal trauma.

Stalker, H P; Kaufman, Robert A.; Stedje, K

doi:10.2214/ajr.154.3.2106223

Cited by 32 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The combined BATp distribution was: acombined with polytrauma in 24 In our study, one important element was the use of laboratory examinations in NOM/OM cases including complete blood analysis (CBA) in 100% of all cases of our study and complete urine analysis in 85% of cases, particularly those with urinary tract trauma (UTT). Skull x-ray (S-xr) was performed in 26 (15%) cases with polytrauma, particularly those with CCT.…”

Section: Table 2: Connections Between the Mode Of Transport And Hdcomentioning

confidence: 77%

Considerations and Evaluations on Abdominal Trauma in Pediatric Age.

Dogjani¹,

Haxhirexha

Selmani³

et al. 2019

AJTES

View full text Add to dashboard Cite

Background: Trauma is the leading cause of morbidity and mortality in pediatric age. Abdominal trauma is the third most frequent cause of trauma injuries in children. The purpose of our study is to discuss BATp epidemiology and its relationship with polytrauma, , to recognize and describe the mechanisms of blunt abdominal trauma in pediatric age and to identify the signs and symptoms that associate it. Material and methods: In this retrospective study we reviewed all patients with blunt abdominal trauma in pediatric age who presented in Emergency Department at the University Hospital of Trauma in Tirana, Albania in the period between December 1-st 2017 and June 24-th 2018. The sample in the study was taken randomly. The Injury Severity Score, Revised Trauma Score were used as important points to evaluate gravity of injuries, and method of treatment. The data was introduced in absolute and percentage values and Kendal's tau b correlation coefficient and the regression analysis was used to analyze and to find out any association among the dependent versus independent variable. The type of study is case control with two components; descriptive and analytical. Results: In the time period that we studied, about 25200 patients were presented in Emergency department and 6.68% of these cases were hospitalized. Most frequent causes were motor vehicle accidents (35.4%) and abdominal trauma comprised 25.8% of cases, whereas in children it comprised 13.7% of total pediatric trauma. We have found correlation between the injury severity score and complications rate (r = 0.254, n = 49, p <0.001), and injury severity score with length of hospital stay (r = 0279, n = 49, p <0.001). Conclusions: Blunt Abdominal Trauma in pediatric age is a serious threat to the health of the children. Their treatment should be carried out not only in tertiary trauma centers but in every regional hospital. The trauma score is very valuable to determine the gravity of the injury, method of treatment and is a predictive tool in trauma outcomes.

show abstract

Section: Table 2: Connections Between the Mode Of Transport And Hdcomentioning

confidence: 77%

Considerations and Evaluations on Abdominal Trauma in Pediatric Age.

Dogjani¹,

Haxhirexha

Selmani³

et al. 2019

AJTES

View full text Add to dashboard Cite

show abstract

“…Several studies have demonstrated that in the absence of other clinical findings, no intra-abdominal injuries were identified in children with asymptomatic hematuria alone 2,11–13 . These studies similarly distinguished significant injuries and insignificant or minor injuries although not all injuries required intervention.…”

Section: Discussionmentioning

confidence: 99%

Presence of Microscopic Hematuria Does Not Predict Clinically Important Intra-Abdominal Injury in Children

Papillon,

Pennell,

Bauer

et al. 2024

Pediatr Emer Care

View full text Add to dashboard Cite

Objective Screening for blunt intra-abdominal injury in children often includes directed laboratory evaluation that guides need for computed tomography. We sought to evaluate the use of urinalysis in identifying patients with clinically important intraabdominal injury (ci-IAI). Methods A retrospective chart review was performed for all patients less than 18 years who presented with blunt mechanisms at a level I trauma center between 2016 and 2019. Exclusion criteria included transfer from an outside facility, physical abuse, and death within thirty minutes of arrival. Demographics, physical exam findings, serum chemistries, urinalysis, and imaging were reviewed. Clinically important intraabdominal injury was defined as injury requiring ≥2 nights admission, blood transfusion, angiography with embolization, or therapeutic surgery. Results Two hundred forty patients were identified. One hundred sixty-five had a completed urinalysis. For all patients an abnormal chemistry panel and abnormal physical exam had a sensitivity of 88.9% and a negative predictive value of 99.3%. Nine patients had a ci-IAI. Patients with a ci-IAI were more likely to have abdominal pain, tenderness on exam, and elevated hepatic enzymes. When patients were stratified by the presence of an abnormal chemistry or physical exam with or without microscopic hematuria, urinalysis did not improve the ability to identify patients with a ci-IAI. In fact, presence of microscopic hematuria increased the rate of false positives by 12%. Conclusions Microscopic hematuria was not a useful marker for ci-IAI and may lead to falsely assuming a more serious injury.

show abstract

“…26,28 However, it remains controversial whether the presence of microscopic haematuria as an isolated finding in a paediatric trauma patient justifies imaging. 26,29–34 We take the approach of Stylianos and Harris: if a child with minimal injury has less then 10 RBC/hpf in urine in the initial specimen, it seems sensible to wait for repeat urine analysis. If the repeat urine analysis shows microscopic haematuria, imaging to rule out renal trauma would seem to be prudent.…”

Section: Investigationsmentioning

confidence: 99%

“…One study that compared the dipstick and microscopic methods for evaluating haematuria found that microscopic evaluation was superior for quantification, although a dipstick test was shown to be sensitive enough for screening patients with trauma. 22 Controversy continues over the amount of haematuria that indicates severe renal injury; Stalker et al claimed than greater than 50 RBC/hpf was significant of renal injury, 23 whereas Lieu and et al believed greater than 20 RBC/hpf was significant. 24 Taylor et al consider that asymptomatic haematuria usually indicates insignificant urinary tract injury.…”

Section: Investigationsmentioning

confidence: 99%

Blunt abdominal trauma in children

Singh²,

Kimble³

2000

J Paediatrics Child Health

View full text Add to dashboard Cite

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.

show abstract

The significance of hematuria in children after blunt abdominal trauma.

Cited by 32 publications

References 8 publications

Considerations and Evaluations on Abdominal Trauma in Pediatric Age.

Considerations and Evaluations on Abdominal Trauma in Pediatric Age.

Presence of Microscopic Hematuria Does Not Predict Clinically Important Intra-Abdominal Injury in Children

Blunt abdominal trauma in children

Contact Info

Product

Resources

About