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Abdominal Trauma 189

Key Summary Points
1. Abdominal trauma in children is mostly due to blunt injuries. 6. A high index of suspicion must be maintained to avoid missing
hollow viscera injuries.
2. Clinical evaluation is the most vital tool in diagnostic
assessment. 7. Patients undergoing splenectomy are at risk of overwhelming
postsplenectomy infection (OPSI), and the child should be
3. When available, FAST, DPL, abdominal CT scan, or diagnostic placed on long-term prophylactic antimalarials (proguanil or
laparoscopy are useful diagnostic adjuncts. pyrimethamine) and receive vaccination against pneumococcal
4. Laparotomy may be needed for definitive diagnosis and infection.
treatment. 8. Anorectal injuries are associated with significant morbidity and
5. Most solid abdominal organ injuries can be managed should be promptly evaluated and treated.
nonoperatively, but the child must be carefully monitored for
signs of deterioration that will require laparotomy.

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