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Other useful references

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.

 

  • Optimal radiological investigation of suspected abdominal injury is a CT scan of the abdomen 1 with or without contrast 2
  • A plain abdominal film may indicate perforation, and ultrasound (U/S) is non-invasive and easily accessible. However, either of these investigations may miss significant injury 2-7
  • A Cochrane review concluded there is no evidence in using U/S in preference to CT scan for blunt abdominal injury as its sensitivity is too low for definitive identification of injury 8

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References

  1. Di Pietro, MA, Brody AS, Cassady CI, Kleinman PK, Wyly JB, Applegate KE, Wood BP, Zerin JM, Mercado-Deane MG, Seibert JJ, Stolic A. Diagnostic imaging of child abuse. Pediatrics. 2009;123(5):1430-1435 [Pubmed]
  2. Sola JE, Cheung MC, Yang R, Koslow S, Lanuti E, Seaver C, Neville HL, Schulman CI. Pediatric FAST and elevated liver transaminases: An effective screening tool in blunt abdominal trauma. The Journal of Surgical Research. 2009;157(1):103-107 [Pubmed]
  3. Holmes JF, Gladman, A, Chang, CH. Performance of abdominal ultrasonography in pediatric blunt trauma patients: a meta-analysis. Journal of Pediatric Surgery. 2007;42(9):1588-1594 [Pubmed]
  4. Lynn KN, Werder, GM, Callaghan, RM, Sullivan, AN, Jafri, ZH, Bloom, DA. Pediatric blunt splenic trauma: a comprehensive review. Pediatric Radiology. 2009;39(9):904-916 [Pubmed]
  5. Retzlaff T, Hirsch, W, Till, H, Rolle, U. Is sonography reliable for the diagnosis of pediatric blunt abdominal trauma? Journal of Pediatric Surgery. 2010;45(5):912-915 [Pubmed]
  6. Richards JR, Knopf, NA, Wang, L, McGahan, JP. Blunt abdominal trauma in children: evaluation with emergency US. Radiology. 2002;222(3):749-754 [Pubmed]
  7. Larimer EL, Fallon SC, Westfall J, Frost M, Wesson DE, Naik-Mathuria BJ. The importance of surgeon involvement in the evaluation of non-accidental trauma patients. Journal of Pediatric Surgery. 2013;48(6):1357-62 [Pubmed]

  8. Stengel D, Bauwens, K, Sehouli, J, Rademacher, G, Mutze, S, Ekkernkamp, A, Porzsolt, F. Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma. Cochrane Database of Systematic Reviews. 2005;118(2) [Pubmed]

 

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