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SHR Neuro Cancer Cardio Lipid Metab Microb
Retzlaff, T; Hirsch, W; Till, H; Rolle, U; .
Is sonography reliable for the diagnosis of pediatric blunt abdominal trauma?.
J Pediatr Surg. 2010; 45(5):912-915
Doi: 10.1016/j.jpedsurg.2010.02.020
Web of Science
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
- Till Holger
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- Abstract:
- Background: Computerized tomography (CT) is considered as the imaging study of choice for blunt abdominal trauma in children. Nevertheless, recent investigations clearly indicate an increased risk of cancer in children exposed to radiation during abdominal spiral CT. Therefore, alternative strategies should be used for the diagnosis and surgical decision making in blunt abdominal trauma in children. Methods: Retrospective analysis included all children with intraabdominal organ rupture after blunt abdominal trauma. Patients were diagnosed by a standardized emergency protocol that included primary clinical assessment and repeated ultrasound but not routine CT. Efficacy of abdominal ultrasound was evaluated in regard to safe diagnosis and appropriate surgical decision making. Results: The study included 35 children with intraabdominal organ rupture diagnosed by ultrasound. One fifth (7/35) of the patients were polytraumatized, whereas 28 of 35 had an isolated blunt abdominal trauma. All patients underwent immediate ultrasound scanning of the abdomen and retroperitoneal space. Two patients were immediately operated because of hemodynamically instability. Four of 7 polytraumatized patients and 7 of 28 patients with isolated blunt abdominal trauma were additionally diagnosed by spiral CT. Only 1 patient underwent subsequent surgery because of the findings in the CT. Ultrasound was effective in more than 97% (34/35) of the patients for diagnosis and appropriate surgical decision making. Conclusion: Ultrasound combined with clinical assessment presents an effective method for safe diagnosis and appropriate surgical decision making in pediatric blunt abdominal trauma. Selected cases with polytrauma and/or unequivocal findings in the ultrasound should undergo abdominal CT. Patients requiring abdominal CT should have an anticipated benefit that exceeds the radiation risk. The importance of repeated clinical assessment cannot be overstated. (C) 2010 Elsevier Inc. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Abdominal Injuries - surgery Abdominal Injuries - ultrasonography
- Adolescent -
- Child -
- Child, Preschool -
- Decision Making -
- Humans -
- Infant -
- Reproducibility of Results -
- Retrospective Studies -
- Rupture -
- Safety -
- Wounds, Nonpenetrating - surgery Wounds, Nonpenetrating - ultrasonography
- Find related publications in this database (Keywords)
- Blunt abdominal trauma
- Children
- Computed tomography
- Ultrasound