title: Computed tomography is not justified in every pediatric blunt trauma patient with a suspicious mechanism of injury.
abstract: OBJECTIVE
  Computed tomography (CT) has become an important tool for the diagnosis of intra-abdominal and chest injuries in patients with blunt trauma. The role of CT in conscious asymptomatic patients with a suspicious mechanism of injury remains controversial. This controversy intensifies in the management of pediatric blunt trauma patients, who are much more susceptible to radiation exposure. The objective of this study was to evaluate the role of abdominal and chest CT imaging in asymptomatic pediatric patients with a suspicious mechanism of injury.
  
  
  METHODS
  Forty-two pediatric patients up to 15 years old were prospectively enrolled. All patients presented with a suspicious mechanism of blunt trauma and multisystem injury. They were neurologically intact and had no signs of injury to the abdomen or chest. Patients underwent CT imaging of the chest and abdomen as part of the initial evaluation.
  
  
  RESULTS
  Thirty-one patients (74%) had a normal CT scan. Two patients of 11 with an abnormal CT scan required a change in management and were referred for observation in the Intensive Care Unit. None of the patients required surgical intervention.
  
  
  CONCLUSIONS
  The routine use of CT in asymptomatic pediatric patients with a suspicious mechanism of blunt trauma injury is not justified.
authors.affiliation: Division of Surgery, Assaf Harofeh Medical Center, Zerifin 70300, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Hershkovitz
authors.affiliation: Division of Surgery, Assaf Harofeh Medical Center, Zerifin 70300, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: Itai
authors.initials: I
authors.lastname: Zoarets
authors.affiliation: Division of Surgery, Assaf Harofeh Medical Center, Zerifin 70300, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: Albert
authors.initials: A
authors.lastname: Stepansky
authors.affiliation: Pediatric Emergency Unit, Assaf Harofeh Medical Center, Zerifin 70300, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Kozer
authors.affiliation: Division of Surgery, Assaf Harofeh Medical Center, Zerifin 70300, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: Zahar
authors.initials: Z
authors.lastname: Shapira
authors.affiliation: Department of Pediatric Surgery, Assaf Harofeh Medical Center, Zerifin 70300, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: Baruch
authors.initials: B
authors.lastname: Klin
authors.affiliation: Division of Surgery, Assaf Harofeh Medical Center, Zerifin 70300, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Halevy
authors.affiliation: Division of Surgery, Assaf Harofeh Medical Center, Zerifin 70300, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel. Electronic address: igorjer65@gmail.com.
authors.forename: Igor
authors.initials: I
authors.lastname: Jeroukhimov
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000058:Accidental Falls; D000063:Accidents, Traffic; D000293:Adolescent; D058070:Asymptomatic Diseases; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003288:Contusions / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D055370:Lung Injury / Q000000981:diagnostic imaging; D008297:Male; D010384:Pelvic Bones / Q000293:injuries; D011030:Pneumothorax / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012253:Rib Fractures / Q000000981:diagnostic imaging; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries; D013898:Thoracic Injuries / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*