Blunt abdominal trauma is the third most common cause of pediatric deaths from trauma, but it is the most common unrecognized fatal injury. The history and physical examination, combined with the mechanism of injury, should be used to develop a thoughtful and directed diagnostic workup. The mainstays of diagnostic evaluation include laboratory testing, sonography, and computed tomography. However, due to the concern for radiation exposure and other risks, the routine use of these studies may not be necessary, and controversy exists as to which studies are beneficial and which are less valuable. This supplement discusses common mechanisms and injuries seen in children with blunt abdominal trauma and takes a closer look at evaluation and management techniques.
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Endovascular management of haemorrhage and vascular lesions in patients with multiple and/or severe injuries: a systematic review and clinical practice guideline update.
Eur J Trauma Emerg Surg
January 2025
Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.
Purpose: Our aim was to update evidence-based and consensus-based recommendations for the inhospital endovascular management of haemorrhage and vascular lesions in patients with multiple and/or severe injuries based on current evidence. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Multiple and/or Severe Injuries.
Methods: MEDLINE and Embase were systematically searched to June 2021.
Performance of individual criteria of the Pediatric Emergency Care Applied Research Network (PECARN) intraabdominal injury prediction rule.
Acad Emerg Med
January 2025
Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California, USA.
Objective: The Pediatric Emergency Care Applied Research Network (PECARN) derived and externally validated a clinical prediction rule to identify children with blunt torso trauma at low risk for intraabdominal injuries undergoing acute intervention (IAI). Little is known about the risk for IAI when only one or two prediction rule variables are positive. We sought to determine the risk for IAI when either one or two PECARN intraabdominal injury rule variables are positive.
View Article and Find Full Text PDFThe Role of Modern Radiological Procedures in Diagnosing Blunt Liver Injuries Manifested by Upper Gastrointestinal Bleeding.
J Clin Med
December 2024
Ist Department of Radiology and Diagnostics Imaging, Faculty of Medicine, Medical University of Lodz, Narutowicza 60, 90-136 Lodz, Poland.
Posttraumatic upper gastrointestinal bleeding (UGIB) is a very rare consequence of blunt liver trauma. It can be quite a diagnostic challenge for clinicians, as it can clinically manifest many weeks after the trauma or be scantily symptomatic. The following article would like to provide an analysis of clinical cases of 13 patients following blunt liver injuries, the main symptoms of which was bleeding into the gastrointestinal tract through the biliary tree.
View Article and Find Full Text PDFThe abdomen does not lie, but the labs might: Predictors of intra-abdominal injury on computed tomography imaging in pediatric blunt trauma patients.
J Trauma Acute Care Surg
January 2025
From the Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona.
Article Synopsis
- This study reviews predictors of intra-abdominal injury in pediatric patients with blunt abdominal trauma using data from a Level II trauma center from 2018 to 2022.
- It found that while various clinical signs and laboratory results were present, a significant number of patients with intra-abdominal injuries (IAI) did not show abnormal lab results, highlighting the complexity in diagnosis.
- Key independent predictors for IAI included abdominal tenderness, abnormal plain x-rays, and positive ultrasound, suggesting that physical exams and imaging are critical in decision-making for CT scans, rather than relying solely on lab results.
Undetermined Ruptured Low-Grade Appendiceal Mucinous Neoplasm Following High-Energy Blunt Abdominal Trauma Requiring Emergency Laparotomy.
Clin Case Rep
January 2025
Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences Okayama University Okayama Japan.
Blunt abdominal trauma causing intraperitoneal injury and/or bleeding can be life-threatening, requiring immediate intervention. Diagnosing these cases can be challenging, especially when pre-existing conditions are involved. Low-grade appendiceal mucinous neoplasm (LAMN) is a rare tumor of the appendix that can lead to pseudomyxoma peritonei.
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