Abdominal trauma

Abstract

Patterns of injury differ between children and adults. Younger age and developmental level increase the frequency of injuries from falls, abuse, bicycles, sports, and pedestrian struck events. Their small, compact nature makes them more susceptible to multisystem injury. There are also many key anatomic and physiologic differences that must be considered. Injuries to intra-abdominal organs are seen in at least 10 % of injured children. Evaluation is more difficult due to a lack of cooperation. While traumatic brain injury remains the leading cause of death in injured children, evaluation for occult abdominal injuries remains one of the greatest challenges. The vast majority of blunt solid organ injuries can be managed non-operatively. Patients requiring operative intervention for hemorrhage are typically either hemodynamically unstable or fail nonoperative management within 24 h. Although hollow viscus injury is uncommon, the majority of trauma laparotomies performed in pediatric trauma centers are for management of intestinal perforation.