Blunt Abdominal Trauma in the Pediatric Patient |
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Authors: | Douglas A. Potoka MD Richard A. Saladino MD |
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Affiliation: | Department of Pediatric Surgery, University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh, PA;†Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh, PA |
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Abstract: | Timely diagnosis and a rational approach to operative versus nonoperative management of intra-abdominal injuries in children are critical to providing optimal pediatric trauma care. Suspicion of IAI is based on the mechanism of injury and findings on examination. Subsequent evaluation and management of IAI is influenced by the patient's hemodynamic status and the presence of extra-abdominal injuries. The hemodynamically unstable patient with suspected IAI requires emergent laparotomy. The hemodynamically stable patient is evaluated using laboratory and imaging studies, most importantly, CT of the abdomen. Stable patients with hepatic or splenic injuries are almost always managed nonoperatively, whereas small bowel, colon, and pancreatic injuries with main duct disruption require laparotomy. |
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Keywords: | abdominal trauma pediatric trauma hemorrhagic shock splenic injury liver injury pancreatic injury |
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