Pediatric abdominal trauma

Abdominal trauma remains a cause of significant morbidity in children despite advances in the care of these patients. Blunt injuries account for approximately 90% of pediatric trauma. According to a review of several trauma databases, approximately 8%-12% of children suffering blunt trauma will have an intra-abdominal injury [1]. Motor vehicle crashes, autopedestrian injuries, and falls constitute the most common mechanisms for blunt abdominal trauma. Other common causes include bicycle accidents, all-terrain vehicle injuries, and child abuse. Fortunately, most of the children suffering blunt abdominal trauma have an excellent prognosis with greater than 90% survival [2]. Nonoperative management (NOM) of the majority of blunt abdominal trauma has become a mainstay since the original advances in the 1960s and 1970s. Since the introduction of observation for blunt splenic laceration and hematoma, pediatric surgeons have continued to push the envelope with regard to minimizing unnecessary operative and diagnostic interventions.