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

Authors:
  • CSC J Sivit
    C J Sivit
  • MEM R Eichelberger
    M R Eichelberger
  • CGC S Gotschall
    C S Gotschall
  • GTG A Taylor
    G A Taylor
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Abstract
The purpose of this study was to evaluate the impact of CT on operative management of children examined after blunt abdominal trauma.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.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 ...