Chapter 15
Pediatric Abdominal Trauma
Daniel Ostlie, MDI. INTRODUCTION
The highest mortality associated with trauma in the pediatric population
is caused by severe head injury. However, abdominal injuries occur in 10-15%
of injured children and continue to lead to significant morbidity and mortality [1].
The most common mechanism leading to abdominal solid organ injury in this
population is motor vehicle related accidents. The most likely injured organ is
the spleen, followed by the liver. Regardless of the mechanism or organ
injured, the pattern of injury does differ in the pediatric population when
compared to the adult population. This is due to the differences in anatomic
and physiologic characteristics of children when compared to adults.
Compared to adults, children have a more compliant abdominal wall and
rib cage, as well as less body fat. These factors all contribute to an increased
risk for abdominal injury due external forces. Physiologically, children manifest
the effects of blood loss much differently than adults, because of their ability to
compensate by increasing heart rate and systemtic vascular resistance to
compensate for blood loss. In children, hypotension is an ominous sign that
suggests impending cardiovascular collapse.
II. EVALUATION