title: Pelvic Free Fluid in Asymptomatic Pediatric Blunt Abdominal Trauma Patients: A Case Series and Review of the Literature.
abstract: BACKGROUND
  With focused assessment with sonography in trauma (FAST) examinations being performed more commonly on pediatric trauma patients, emergency providers will encounter a positive FAST examination in patients with benign abdominal examinations. This poses a diagnostic dilemma for the provider when deciding whether to obtain a computed tomography (CT) scan of the abdomen/pelvis, observe the patient, or admit the patient.
  
  
  METHODS
  We report a series of pediatric patients involved in blunt abdominal trauma who had small pelvic free fluid on FAST but a benign abdominal examination. Three patients were managed without CT scan and 2 with CT scan. All patients did well and were discharged home. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Free intra-abdominal fluid may be physiologic in both male and female pediatric patients. Clinical examination and hemodynamic stability should be taken into account when deciding to order a CT scan. We review the literature and highlight new protocols that may decrease CT utilization and ionizing radiation exposure, though further studies in this specific population are needed.
authors.affiliation: Keck School of Medicine of the University of Southern California, Department of Emergency Medicine, Los Angeles County + USC Medical Center, Los Angeles, California.
authors.forename: Kristin
authors.initials: K
authors.lastname: Berona
authors.affiliation: Keck School of Medicine of the University of Southern California, Department of Emergency Medicine, Los Angeles County + USC Medical Center, Los Angeles, California.
authors.forename: Tarina
authors.initials: T
authors.lastname: Kang
authors.affiliation: Keck School of Medicine of the University of Southern California, Department of Emergency Medicine, Los Angeles County + USC Medical Center, Los Angeles, California.
authors.forename: Emily
authors.initials: E
authors.lastname: Rose
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D014463:Ultrasonography / Q000379:methods*; D014947:Wounds and Injuries / Q000150:complications / Q000503:physiopathology; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000503:physiopathology
keywords: pediatrics; trauma; ultrasound