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abdominal trauma
Clinical manifestations:
1) abdominal pain
2) signs of peritoneal irritation on physical exam
3) hemodynamic instability
Laboratory:
1) complete blood count
- hemoglobin/hematocrit
- white blood cell count
2) serum chemistries
a) serum aspartate aminotransferase (AST)
b) serum alanine aminotransferase (ALT)
c) serum lactate dehydrogenase
d) serum lipase
e) serum creatinine
3) urinalysis
Special laboratory:
- abdominal ultrasound
- initial diagnostic mode in hemodynamically unstable patients
- doppler evaluation of the renal arteries
- determines need for emergent laparotomy
- abdominal ultrasound in the emergency department (bedside focused assessment with sonography for trauma -> FAST) for children with blunt abdominal trauma doesn't seem to improve clinical care or lower costs [1]
Radiology:
- abdominal computed tomography, IV contrast only
Management:
- see abdominal pain
Related
abdominal pain
Blunt Abdominal Trauma in Children score (BATiC)
General
torso trauma; trunk trauma; injury of thorax, abdomen, &/or pelvis
References
- Holmes JF, Kelley KM, Wootton-Gorges SL
Effect of Abdominal Ultrasound on Clinical Care, Outcomes, and
Resource Use Among Children With Blunt Torso Trauma. A
Randomized Clinical Trial.
JAMA. 2017;317(22):2290-2296
PMID: 28609532
http://jamanetwork.com/journals/jama/article-abstract/2631528
- Kessler DO
Abdominal Ultrasound for Pediatric Blunt Trauma. FAST Is Not
Always Better.
JAMA. 2017;317(22):2283-2285
PMID: 28609517
http://jamanetwork.com/journals/jama/article-abstract/2631512