American Journal of Roentgenology, Vol 169, 1011-1014, Copyright © 1997 by American Roentgen Ray Society

ARTICLES

Blunt abdominal trauma in children: impact of CT on operative and nonoperative management

L Ruess, CJ Sivit, MR Eichelberger, CS Gotschall and GA Taylor
Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC 20010, USA.

OBJECTIVE: The purpose of this study was to evaluate the impact of CT on operative management of children examined after blunt abdominal trauma. SUBJECTS AND METHODS: Fifteen-hundred consecutive children who sustained blunt abdominal trauma were prospectively examined with CT. CT findings and the decision for operative or nonoperative management were recorded prospectively. In the children who underwent laparotomy, indications for operative intervention as determined by the attending trauma surgeon and surgical findings were also recorded. RESULTS: Three hundred eighty-eight (26%) of the CT scans had abnormal findings: solid viscus injury, 286; other CT abnormality, 102. Twenty (7%) of 286 children with a solid viscus injury and 25 (83%) of 30 children with a hollow viscus injury underwent therapeutic laparotomy. Abnormalities seen on CT were noted in all 20 children with solid viscus injury and 24 of 25 children with hollow viscus injury who underwent therapeutic laparotomy. The decision for laparotomy was based on CT findings in five (25%) of 20 children with solid viscus injury and 17 (68%) of 25 children with hollow viscus injury. Eleven hundred twelve children (74%) had normal findings on CT. Only one of these children later required laparotomy. CONCLUSION: CT rarely influenced the decision for operative intervention in children who sustained blunt abdominal trauma. CT findings affected the decision for operative intervention in most children with hollow viscus injury; however, CT findings affected such a decision in only a small subset of children with solid viscus injury. Normal abdominal CT findings strongly predicted a lack of subsequent deterioration requiring operative intervention.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				E J HALL and D J BRENNER Cancer risks from diagnostic radiology Br. J. Radiol., May 1, 2008; 81(965): 362 - 378. [Abstract] [Full Text] [PDF]

				M. Valentino, C. Serra, P. Pavlica, A. M. Morselli Labate, M. Lima, S. Baroncini, and L. Barozzi Blunt Abdominal Trauma: Diagnostic Performance of Contrast-enhanced US in Children--Initial Experience Radiology, March 1, 2008; 246(3): 903 - 909. [Abstract] [Full Text] [PDF]

				D. J. Brenner and E. J. Hall Computed Tomography -- An Increasing Source of Radiation Exposure N. Engl. J. Med., November 29, 2007; 357(22): 2277 - 2284. [Full Text] [PDF]

				F Abbasakoor and C Vaizey Pathophysiology and management of bowel and mesenteric injuries due to blunt trauma Trauma, October 1, 2003; 5(4): 199 - 214. [Abstract] [PDF]

				M. Soudack, M. Epelman, and D. Gaitini Spontaneous Thrombosis of Hepatic Posttraumatic Pseudoaneurysms: Sonographic and Computed Tomographic Features J. Ultrasound Med., January 1, 2003; 22(1): 99 - 103. [Full Text] [PDF]

				J. P H Lam, G. J Eunson, F. D Munro, and J. D Orr Lesson of the week: Delayed presentation of handlebar injuries in children BMJ, May 26, 2001; 322(7297): 1288 - 1289. [Full Text] [PDF]

				L. A. Kory Thrombosis of the Abdominal Aorta in a Child After Blunt Trauma Am. J. Roentgenol., August 1, 2000; 175(2): 553 - 554. [Full Text] [PDF]

				M. L Ramenofsky and S. Cash Clinical evaluation of the child: injury to the chest and abdomen Trauma, October 1, 1999; 1(4): 313 - 322. [Abstract] [PDF]

				P. J. Strouse, B. J. Close, K. W. Marshall, and R. Cywes CT of Bowel and Mesenteric Trauma in Children RadioGraphics, September 1, 1999; 19(5): 1237 - 1250. [Abstract] [Full Text] [PDF]