Emergency department evaluation and management of blunt abdominal trauma in children.
OBJECTIVE
To discuss the emergency department evaluation and management of children with blunt abdominal trauma. The review will focus on both the clinical data that can help reduce the use of computed tomography in the evaluation of patients with blunt abdominal trauma and the evidence for the increased use of nonoperative management of patients with blunt abdominal trauma.


RESULTS
We will examine the recent literature focusing on the utility of physical examination, laboratory data and imaging (both ultrasonography and computed tomography) in detecting intraabdominal injury.


CONCLUSIONS
Recent research suggests that physical examination in combination with bedside ultrasonography may identify children at risk for intraabdominal injury. Screening laboratory data appears to be less sensitive to detect these injuries, but is useful in selected patients. Nonoperative management is appropriate in a majority of cases. Further research is needed to determine which low-risk patients with abdominal trauma can be managed with minimal or no exposure to radiation in the computed tomography scanner.
Eppich
Walter J
WJ
Division of Pediatric Emergency Medicine, Northwestern University Feinberg School of Medicine, Children's Memorial Hospital, 2300 Children's Plaza #62, Chicago, IL 60614, USA. weppich@childrensmemorial.org
Zonfrillo
Mark R
MR
D000007:Abdominal Injuries / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D004636:Emergency Service, Hospital; D006801:Humans; D010808:Physical Examination; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000628:therapy*