Abdominal injuries

Abstract

Abdominal injuries make up a small percentage of sports-related injuries, with a recent 10-year review demonstrating an incidence of 0.56% of pediatric sports-related injuries due to abdominal or testicular trauma. Despite the relatively low incidence, the outcome of abdominal injuries can be poor, even including death, making the diagnosis, management, and treatment of such injuries of the utmost importance. The most commonly injured organs from blunt abdominal trauma are the spleen, kidney, intestines, and liver. These injuries can result from direct or indirect trauma, often presenting without overt signs of trauma. Frequently, symptoms can present with a delayed onset or not at all and therefore, knowledge of the mechanism of injury is important. Athletes with suspected abdominal injuries should be directed to a facility appropriately equipped to manage such injuries, with access to CT, angiography, on-demand surgical capabilities, and ability for continuous monitoring. Management decisions are determined by the hemodynamic status of the athlete. CT in most cases is the diagnostic modality of choice, with Focused Assessment with Sonography for Trauma examination used in the initial workup. In the hemodynamically stable athlete, the treatment of choice is nonsurgical. Many organ systems have grading systems based on CT scans. There is no consensus for return-to-play decisions and often the degree of injury is a factor. In all cases, attention to the readiness of the athlete to return to play should be based on normalization of their physical findings-laboratory examination, hemodynamic status with evidence of continued injury-and psychologic preparedness.