Pediatric emergency medicine trisk 3177 3177
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Signs and Symptoms
Abdominal Distention: Chapter 12
Pain: Abdomen: Chapter 53
Medical, Surgical, and Trauma Emergencies
Genitourinary Trauma: Chapter 108
Musculoskeletal Trauma: Chapter 111
Thoracic Trauma: Chapter 115
Procedures and Appendices
Ultrasound: Chapter 131
THE APPROACH TO THE PEDIATRIC PATIENT WITH
ABDOMINAL TRAUMA
CLINICAL PEARLS AND PITFALLS
Priorities in evaluation and treatment of any child with trauma include
recognition and relief of airway obstruction, appropriate protection of
the cervical spine, and identification and management of lifethreatening injuries and shock.
Once resuscitation has been initiated, evaluation of the abdomen is
included in both the primary and secondary surveys.
Occult abdominal trauma occurs in many settings, including children
restrained only by a lap belt, bicycle handlebar related, and in child
abuse. Index of suspicion must be high in these cases.
Current Evidence
Blunt injuries account for most of the morbidity and mortality of childhood
trauma, although the frequency with which penetrating injuries occur is
increasing. Traumatic brain injury is the leading cause of injury-related death in
children; hemorrhage, often from an intra-abdominal source, is the leading cause
of preventable death.
Goals of Treatment
The primary objective of the trauma survey is the systematic identification of
injuries. The evaluation for intra-abdominal injuries in children starts with an
understanding of the mechanism of trauma, elicited from witnesses, caregivers,
