title: Blunt abdominal trauma in children.
abstract: OBJECTIVE
  This review will examine the current evidence regarding pediatric blunt abdominal trauma and the physical exam findings, laboratory values, and radiographic imaging associated with the diagnosis of intra-abdominal injuries (IAI), as well as review the current literature on pediatric hollow viscus injuries and emergency department disposition after diagnosis.
  
  
  RESULTS
  The importance of the seat belt sign on physical examination and screening laboratory data remains controversial, although screening hepatic enzymes are recommended in the evaluation of nonaccidental trauma to identify occult abdominal organ injuries. Focused Assessment with Sonography for Trauma (FAST) has modest sensitivity for hemoperitoneum and IAI in the pediatric trauma patient. Patients with concern for undiagnosed IAI, including bowel injury, may be considered for hospital admission and serial abdominal exams without an increased risk of complications, if an exploratory laparotomy is not performed emergently.
  
  
  CONCLUSIONS
  Although the FAST exam is not recommended as the sole screening tool to rule out IAI in hemodynamically stable trauma patients, it may be used in conjunction with the physical exam and laboratory findings to identify children at risk for IAI. Children with a normal physical exam and normal abdominal CT may not require routine hospitalization after blunt abdominal trauma.
authors.affiliation: Division of Emergency Medicine, Children's Hospital, Boston, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Schonfeld
authors.forename: Lois K
authors.initials: LK
authors.lastname: Lee
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002648:Child; D006760:Hospitalization; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging / Q000293:injuries; D010808:Physical Examination / Q000379:methods; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000000981:diagnostic imaging