Abstract
Purpose: Accurate diagnosis of blunt abdominal trauma is often difficult in pediatric patients because initial symptoms may appear mild even in severe cases. This paper is concerned with initial approach to pediatric blunt abdominal trauma. Subjects and Methods: The subjects were six children with blunt abdominal trauma involving organ damage from 1999 to 2007. These cases were reviewed for the conditions at the initial examination and for the courses up to definite diagnosis. Results: Average age was 8.7 years, 5 males and 1 female. In the splenic/left kidney case and one of the jejunal perforation cases, definite diagnosis was obtained from CT images at the initial examination. In the remaining 4 cases, definite diagnosis was not made at the initial examination. In 2 pancreatic damage cases, although the level of serum amylase was elevated, only mild abdominal pain was observed. Definite diagnosis was made the next day. In the duodenal perforation case, only mild abdominal pain was observed and conservative treatment was performed. Definite diagnosis was obtained from the second CT scan after 5 days. In another jejunal perforation case, the initial abdominal symptom was mild and tests showed no abnormalities. Rapid exacerbation took place and definite diagnosis was made at the second examination after about 12 hours. Conclusion: In the examination of pediatric blunt abdominal trauma, it's very important that possible organ damage should always be taken into consideration, blood and urine testing and abdominal US or CT scan should be conducted, and time-course observation should be made.
