Pediatric blunt abdominal trauma: recognition and management in the emergency department

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.