Other mechanisms of concern that should prompt close evaluation for IAI include children in a motor vehicle collision wearing only lap belt restraints, automobile versus bicycle accident, all-terrain vehicle accidents, handlebar injuries from bicycles, and sports or nonaccidental trauma resulting in direct blows to the abdomen. Motor vehicle collisions (without proper restraint and ejection from a vehicle), automobile versus pedestrian accidents, and falls are associated with the greatest increased risk of IAI.
Mechanism of injury Consideration of the cause of blunt pediatric abdominal trauma has been a major decision point for pediatric trauma system activation and deciding how to evaluate a child for potential IAI. doi: /j.pcl Ģ 244 wegner et al including length of hospitalization and return to activity recommendations for children with intra-abdominal injuries (IAI). Wegner) /06/$ see front matter D 2006 Elsevier Inc. Finally, we discuss some of the disposition issues, T Corresponding author. We also briefly review select organ trauma, including trauma that involves liver, spleen, intestines, pancreas, and kidneys. In this article we discuss key issues to help clinicians efficiently and successfully evaluate and manage blunt pediatric abdominal trauma. All clinicians who care for children with potential blunt abdominal injuries should be aware of current concepts related to the diagnosis and treatment of pediatric blunt abdominal trauma.
Nationwide, injured children are cared for not only at dedicated pediatric trauma centers but also in emergency departments and clinics that may not routinely evaluate children for these injuries. In certain scenarios, particularly in preverbal children or children with a decreased level of consciousness, identification of an abdominal injury can be challenging, and failure to detect these injuries initially can lead to preventable complications. Although abdominal trauma is less common than isolated head injury, it is still a leading cause of morbidity and mortality in children. According to the national pediatric trauma registry, each year approximately 1.5 million children are injured, resulting in 500,000 pediatric hospitalizations, 120,000 children with permanent disability, and 20,000 deaths. Paul, MN, USA c Division of Emergency Medicine, Department of Surgery, Department of Pediatrics, University of Maryland School of Medicine, 110 South Paca Street, Sixth Floor, Suite 200, Baltimore, MD 21201, USA Despite increased awareness and prevention efforts, trauma remains the number one cause of childhood death and disability. Colletti, MD b, Donald Van Wie, DO c a Emergency Medical Services, Blackfeet Community Hospital, PO Box 760, Browning, MT 59417, USA b Emergency Medicine Regions Hospital, 640 Jackson Street, St.
1 Pediatr Clin N Am 53 (2006) Pediatric Blunt Abdominal Trauma Stephen Wegner, MD a, T, James E.
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